Predictive efficacy of combined determination of serum SChE,LCR and Apache-Ⅱ score for prognosis of patients with septic shock

Zheng Longxiang; Wu Bin; Wu Zezhi

doi:10.3969/j.issn.1674-3245.2025.04.022

Abstract：Objective To explore the application value of combined determination of serum cholinesterase(SChE),lactate clearance rate(LCR),acute physiology and chronic health evaluation Ⅱ(APACHE-Ⅱ)score in predicting the prognosis of patients with septic shock.Methods The clinical data of 120 patients with septic shock treated in the First Affiliated Hospital of Naval Medical University from January 2022 to January 2024 were retrospectively analyzed.Basic data including age,gender,past medical history,APACHE-Ⅱ score,serum cholinesterase(SChE),lactate clearance rate(LCR),white blood cell count(WBC),albumin,smoking and drinking history,fibrinogen,and other relevant variables were collected for the two groups.According to the prognosis of 28 days of treatment,the selected patients were divided into survival group and death group.Logistic regression septic shock ion analysis was carried out to obtain the high-risk factors affecting the prognosis of septic shock patients;Another 60 patients with septic shock in the same period were selected as the validation group for external validation;ROC curve was drawn to analyze the efficacy of combined determination of serum SChE and LCR in predicting the prognosis of septic shock patients.Results Among 120 patients with septic shock,45 died and 75 survived after 28 days;Univariate analysis showed that APACHE-Ⅱ score,SChE,LCR were related to the prognosis of septic shock patients,with statistical differences(t=19.306,9.362,31.801,P＜0.05);Multiple factors showed that APACHE-Ⅱ score,SChE and LCR were high risk factors affecting the prognosis of septic shock patients(P＜0.05,and OR＞1).The ROC curve showed that the value of combined detection of SChE,LCR and APACHE-Ⅱ score in predicting the prognosis of septic shock patients was 0.741,0.737,0.690 and 0.977,and the value of combined detection was high.Among the 60 patients in the validation group,15 died.The APACHE-Ⅱ score,SChE and LCR of 60 patients in the validation group were substituted into the prognosis prediction model to judge the occurrence of death in 16 cases,with a sensitivity of 93.33％(14/15)and a specificity of 95.56％(43/45).Conclusion The combined measurement of serum SChE and LCR is of high value in the prognosis prediction of septic shock patients,which facilitates the early identification of high-risk groups,improves the treatment plan,and reduces the risk of later death.