Correlation of proprotein convertase subtilisin/kexin type 9,procalcitonin/albumin and lactate levels with short-term prognosis in sepsis patients

Jiang Weiqiang; Du Liwen

doi:10.3969/j.issn.1002-1949.2025.04.006

Abstract：Objective To explore the correlation of proprotein convertase subtilisin/kexin type 9(PSCK9),procalcitonin/albumin(PCT/ALB)and lactate levels with short-term prognosis in sepsis patients.Methods A total of 268 emergency sepsis patients admitted to the emergency intensive care unit of our hospital from August 2021 to November 2024 were selected as the research subjects.According to their survival status within 30 days after admission,they were divided into the good short-term prognosis group(n=193)and the poor short-term prognosis group(n=75).The general clinical data,subjective disease severity scores,PSCK9,PCT/ALB,lactate and other indicators of the two groups were compared in terms of characteristics and differences.Univariate and multivariate Logistic regression analyses were used to evaluate the correlation between each indicator and the short-term prognosis of emergency sepsis patients.The efficacy and differences of independent or combined prediction of the relevant indexes were evaluated by the receiver operating characteristic(ROC)curve and the area under curve(AUC)test.The effectiveness and accuracy of the model for predicting poor short-term prognosis in sepsis patients were evaluated by the decision curve and calibration curve.Results The acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score,age,serum PSCK9,PCT/ALB and lactate in the poor short-term prognosis group were higher than those in the good short-term prognosis group(P<0.05).Univariate and multivariate Logistic regression analyses showed that the APACHEⅡ score,SOFA score,serum PSCK9,PCT/ALB and lactate were independent risk factors for poor short-term prognosis in emergency sepsis patients(P<0.05).ROC curve analysis showed that the AUC(95%CI)of the combined prediction for poor short-term prognosis in emergency sepsis patients by APACHEⅡ score,SOFA score,PSCK9,PCT/ALB and lactate was 0.719(0.647-0.791)(P<0.05).Calibration curve analysis indicated that the prediction model based on the APACHEⅡscore,SOFA score,PSCK9,PCT/ALB and lactate had a good calibration degree(Hosmer-Lemeshow χ2=11.956,P=0.153),and decision curve analysis showed that when the high-risk threshold was in the range of 0-0.80,the net benefit rate of the model prediction was>0.Conclusions In emergency sepsis patients,APACHEⅡ,SOFA,serum PSCK9,PCT/ALB and lactate are closely related to poor short-term prognosis.Moreover,the combined use of the above-mentioned indicators has the highest efficacy in assisting the prediction of the short-term prognosis of emergency sepsis patients.