The Predictive Value of Wei-Qi-Ying-Xue Syndrome Combined with AGI Score for 28-Day Mortality in Sepsis Patients
WANG Fei
WANG Jingjing
YANG Ai
GU Qun
GUO Jianwei
ZHANG Guopeng
Abstract：Objective This study aimed to investigate the correlation between Wei-Qi-Ying-Xue syndrome classification combined with the AGI score and the 28-day mortality in patients with sepsis.Methods A retrospec-tive case-control study was conducted,including 180 sepsis patients admitted from May 2021 to May 2024.Based on the Wei-Qi-Ying-Xue syndrome classification,the patients were divided into three groups:Qi syndrome(73 cas-es),Ying syndrome(48 cases),and Xue syndrome(59 cases).Statistical analyses were performed using SPSS 26.0,and Lasso regression was conducted using R 4.2.1 to select variables and construct predictive models(ROC,DCA analysis).Dynamic changes in disease severity(APACHE Ⅱ,SOFA,AGI score),inflammatory mark-ers(NLR,Neu,Lym),and metabolic markers(Lac,HDL)were compared with 28-day outcomes.Re-sults MODS,NLR,Lac,HDL,APACHE Ⅱ score,and AGI score were significant indicators influencing the 28-day mortality of sepsis patients across the Wei-Qi-Ying-Xue syndrome types.Among these,AGI score and MODS had a significant impact on 28-day mortality(P＜0.05).The AGI score showed a positive correlation with the severity of syndrome types(Qi:1.34±0.87;Ying:2.00±1.13;Xue:2.37±0.92,Kruskal-Wallis H=32.72,P＜0.001),with a more severe syndrome corresponding to a higher predictive value for mortality(P＜0.05).Multivariable Lasso regression revealed that Qi syndrome was primarily influenced by MODS,Lac on the 7th day,APACHE Ⅱ score,AGI score,and the last NLR(λ=0.1032);Ying syndrome added Neu on the last day and NLR on the 5th day(λ=0.1049);Xue syndrome was primarily influenced by MODS,AGI score,and HDL(λ=0.435).ROC curves confirmed that the predictive performance of the indicators was good(AUC＞0.689),and the combined prediction of multiple indicators was significantly better(AUC 0.895-0.971).DCA analysis further validated the clinical utility of AGI score and MODS,with the value of AGI score increasing with syndrome severity(Xue＞Ying＞Qi).Conclusion The Wei-Qi-Ying-Xue syndrome classification is significantly associated with AGI score,and the predictive value of AGI score for 28-day mortality increases with the severity of syndrome types.Both MODS and AGI score are key cross-syndrome predictive indicators,suggesting that gastrointestinal dysfunction may play a critical role in the progression of sepsis to multiple organ failure.Early improvement of gastrointestinal function in sepsis patients is important for preventing the occurrence of multiple organ dysfunction and halting the progression of sepsis
Keywords：Wei-Qi-Ying-Xue syndromeSepsisAcute gastrointestinal dysfunction
Publication Date：2025-06-28
Online Publishing Date：2025-10-28(First online date of this platform, not the publication date of the document)
Pages：7( 629-634,640 )