Analysis of influencing factors and predictive efficacy of related indicators on clinical prognosis in patients with severe sepsis

Lin Wenjia; Huang Jinyu; Gan Rizhi; Yang Chunlan

doi:10.3760/j.issn.1673-4777.2024.01.018

Abstract：Objective To explore the influencing factors and predictive efficacy of related indicators on patients with severe sepsis,in order to provide more references for the screening of high-risk groups with poor prognosis and the formulation of clinical treatment plans.Methods From January 2018 to December 2022,the clinical data of 266 patients with severe sepsis admitted to Affiliated Hospital of Guangdong Medical University were collected as retrospective analysis.They were divided into survival group(180 cases)and death group(86 cases)according to whether they died 28 d after entering the intensive care unit(ICU).The baseline clinical characteristics of the survival group and the death group were compared,the influencing factors of death of patients with severe sepsis 28 d after entering ICU were evaluated by multivariate Logistic regression method,and the predictive effect of relevant indicators on the death of patients with severe sepsis 28 d after entering ICU was analyzed.Results Sequential organ failure assessment score,simplified acute physiology score Ⅱ(SAPS Ⅱ)score,procalcitonin level,C-reactive protein level,and the decrease of platelet count at 24 and 48 h after entering ICU in the death group were higher/greater than those in the survival group(all P＜0.001).Multivariate Logistic regression analysis showed that SAPS Ⅱ score and the decrease of platelet count at 24 and 48 h after entering ICU were independent risk factors for death of patients with severe sepsis 28 d after entering ICU(odds ratio=1.197,1.082,1.057,95％confidence interval:1.125-1.275,1.053-1.112,1.034-1.080,all P＜0.001).The analysis results of the receiver operating characteristic curve showed that SAPS Ⅱ score,the decrease of platelet count at 24 and 48 h after entering ICU,and the combined Youden index of the three were 0.394,0.382,0.376 and 0.626,respectively,and the combined prediction effect of the three was the best.Conclusion The death of patients with severe sepsis 28 d after entering ICU is related to SAPS Ⅱ score and the decrease of platelet count at 24 and 48 h after entering ICU.The combination of above indicators is more effective in predicting the death risk of patients with severe sepsis 28 d after entering ICU.