The significance of myocardial injury markers combined with APACHEⅡ score in predicting prognosis of patients with septic shock

doi:10.3969/j.issn.1002-1949.2015.05.001

Abstract：Objective The aim of this study was to investigate the significance of myocardial injury markers combined with APACHEⅡscore in predicting the prognosis of patients with septic shock. Methods Clinical data of 82 patients with septic shock were analyzed retrospectively.The serum concentration of MYO, CK-MB, NT-proBNP, cTnT in patients with septic shock were measured on the day of definite diagnosis.The APACHEⅡscore was calculated and the risk of death was predicted according to APACHEⅡ score, and the survival rate of 28 days were followed up.The relationship between MYO, CK-MB, NT-proBNP, cTnT level and prognosis was analyzed.Results In patients with septic shock, 45.1% of patients had elevated serum CK-MB, 63.4% of patients had elevated serum cTnT, 78.0%of patients had elevated serum MYO, 93.9%of patients had elevated serum NT-proBNP.Compared with survival group, serum levels of MYO, CK-MB and cTnT were higher in death group (P<0.05).In patients with MODS, the serum levels of MYO, CK-MB, NT-proBNP and mortality were higher than those in patients without MODS (P<0.05).MYO, CK-MB, cTnT and APACHEⅡscore had statistical significance in predicting death ( area under ROC curve was 0.673, 0.703, 0.719 and 0.851 respectively, P<0.05).The area under ROC curve of MYO, CK-MB, cTnT and NT-proBNP to predict death together was 0.749 (P<0.05).The area under ROC curve was 0.874 (P<0.05) when MYO, CK-MB, cTnT and NT-proBNP were combined with APACHEⅡscore, which was higher than APACHEⅡscore or myocardial injury markers alone in predicting death. Conclusion Serum levels of myocardial injury markers were higher in death group and group with MODS.MYO, CK-MB and cTnT have predictive effect for the prognosis of patients with septic shock. High serum MYO, CK-MB, cTnT predicts higher mortality in patients with septic shock.Myocardial injury markers combined with APACHEⅡ score have important predictive value for the prognosis of patients with septic shock.