Predictive value of serum potassium,lactic acid,RDW/PLT at admission in patients presenting with septic shock associated with emergency bloodstream infections in relation to condition and prognosis
OBJECTIVE To investigate the diagnostic value of blood potassium,lactic acid,and red blood cell distri-bution width(RDW)/platelet count(PLT)in the condition and prognosis of patients with septic shock from bloodstream infections.METHODS Totally 50 patients with septic shock due to bloodstream infection treated at Tianjin Teda Hospital from Feb.2016 to Feb.2024 were selected as the study group,and 50 patients with blood-stream infection who did not experience septic shock treated at the same hospital during the same period were se-lected as the control group.According to the survival status of the patients at 28 d after treatment,the study group was further subdivided into the survival group and the death group to investigate the impact of different treatment strategies on the prognosis of the patients.Differences in the levels of blood potassium,lactic acid,and RDW/PLT levels were analyzed in each group of patients and the risk factors for bloodstream infectious septic shock were summarized.Additionally,a receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to assess the diagnostic and predictive value of blood potassium,lactate,and RDW/PLT ratio levels in bloodstream infectious septic shock.RESULTS Blood potassium,lactic acid,and RDW/PLT ratio in the study group were(4.13±0.58)mmol/L,(2.86±0.37)mmol/L,and(0.16±0.05),re-spectively,significantly higher than those of the control group(P＜0.05).Blood potassium(OR=1.411,95％CI:1.003-1.948),lactic acid(OR=1.519,95％CI:1.237-1.866),and RDW/PLT ratio(OR=1.226,95％CI:1.173-1.782)were the independent risk factors for septic shock in bloodstream infections(P＜0.05).The AUC values of blood potassium,lactic acid,and RDW/PLT ratio alone and combined detection for the diag-nosis of septic shock complicated with bloodstream infection were 0.762,0.920,0.775 and 0.954,respectively.After 28-day of follow-up,blood potassium,lactic acid,and RDW/PLT levels in the death group were(4.37±0.62)mmol/L,(3.09±0.34)mmol/L,and 0.20±0.07,respectively,significantly higher than those in the survi-vor group(P＜0.05).The combined application of blood potassium,lactic acid,and RDW/PLT demonstrated the highest prognostic efficacy in patients with septic shock and bloodstream infection,with an AUC value of 0.867.CONCLUSION Blood potassium,lactic acid,and RDW/PLT ratio were closely related to the degree of condition of septic shock patients with coexisting bloodstream infections,which could affect the prognosis of the patients,and could be used as potential clinical indicators for the prediction of the condition and prognosis of septic shock with coexisting bloodstream infections.
Blood potassiumLactic acidRed blood cell distribution width/piatelet ratioBloodstream infectionSepsisPrognosisPredictive value
万方数据
维普
