Analysis of prognostic factors and construction of a predictive model for patients with sepsis complicated by tuberculosis infection with positive T-SPOT Results
CUI Chunxia
ZHU Wangming
TIAN Ronghua
Abstract：Objective To explore prognostic factors and construct a prognostic model for sepsis patients with tuberculosis coinfection and positive T-SPOT results.Methods A total of 93 patients with sepsis complicated with tuberculosis infection and positive T-SPOT results,treated between June 2021 and June 2024,were enrolled as the research subjects.The patients were divided into the good prognosis group(n=56)and the poor prognosis group(n=37)based on follow-up outcomes.The differences in C-reactive protein(CRP)levels,heparin-binding protein(HBP)levels,Acute Physiology,Age and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores,and Sequential Organ Failure Assessment(SOFA)scores were compared between the two groups.The correlations among the variables were determined with Pearson correlation analysis,and the prognostic factors of patients were analyzed through multivariate Logistic regression.The specific prognostic value of these influencing factors was analyzed using the receiver operating characteristic(ROC)curve.Results Compared with the good prognosis group,the poor prognosis group exhibited higher levels of CRP and HBP,as well as higher APACHEⅡ and SOFA scores(P<0.05).HBP and CRP were positively correlated with APACHEⅡ score and SOFA score in the poor prognosis group(P<0.01).Elevated CRP,elevated HBP,high APACHEⅡ scores,and high SOFA scores were all risk factors for poor prognosis in sepsis patients with tuberculosis infection who tested positive by T-SPOT test(P<0.05,P<0.01).The combination of HBP,CRP,APACHEⅡ,and SOFA scores demonstrated the highest predictive efficacy for the prognosis of patients with sepsis complicated by TB infection who tested positive for T-SPOT,with an area under the curve of 0.914.Conclusion Elevated HBP,elevated CRP,high APACHEⅡ score,and high SOFA score are independent risk factors for poor prognosis in sepsis patients with tuberculosis infection and positive T-SPOT results.Each of these four indicators can serve as a biomarker for predicting poor prognosis,and moreover,their combination has higher predictive efficacy.
Keywords：sepsisT-cell spot testC-reactive proteinheparin-binding proteinacute physiologyage and chronic health evaluationⅡsequential organ failure assessment
Publication Date：2025-08-28
Online Publishing Date：2025-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 20-24 )