Dynamic Immune Indicator Changes as Predictors of ARDS in ICU Patients with Sepsis: A Retrospective Study

Understanding the dynamic changes in immune indicators during sepsis and their predictive value for Acute respiratory distress syndrome (ARDS) is crucial for improving patient outcomes.

This single-center, observational retrospective study was conducted at Lishui Central Hospital, Zhejiang Province. Patients diagnosed with Sepsis-3 were categorized into non-ARDS and ARDS groups based on ARDS development. Data collection included demographics, clinical data, and immune parameters. Immune parameters were collected on days 1, 3, and 7 post-admission. Multivariate logistic regression analysis identified independent risk factors for ARDS, and a nomogram model was constructed. The predictive ability of the model was evaluated using ROC curves.

Multivariate analysis identified key factors for the nomogram, including CD4, CD8, Treg, lymphocyte, IgG, and IgA levels on Days 3 and 7. On Day 3, CD8 (P < 0.001), Tregs (P = 0.021), IgG (P < 0.001), and IgA (P < 0.001) showed significant negative correlations with ARDS development. On Day 7, CD4 (P < 0.001), CD8 (P < 0.001), lymphocyte count (P < 0.001), and IgA (P < 0.001) similarly demonstrated significant negative correlations with ARDS risk. The nomogram model had an AUC of 0.998 (95% CI: 0.997-0.999), indicating high predictive ability.

Early dynamic changes in immune indicators, including CD8, CD4, Treg, IgA, IgG, and Lymphocyte, predict ARDS development in ICU sepsis patients.