Randomized Evaluation of Nutritional Risk Screening and HLA-DMB Gene Expression in Early Prediction of Sepsis

Sepsis, a life-threatening syndrome with escalating mortality per treatment delay, requires prognostic tools beyond current Sepsis-3 criteria. This study investigated the dual predictive capacity of Nutrition Risk Screening 2002 (NRS-2002) and Human Leukocyte Antigen-DMB (HLA-DMB), proposing a novel early-warning framework for sepsis risk stratification.

This case-control study enrolled 90 patients with acute infections from the Department of Pulmonary and Critical Care Medicine at Hefei Second People's Hospital. Participants were stratified into sepsis (n = 45) and non-sepsis (n = 45) groups according to Sepsis-3 diagnostic criteria. Clinical baseline characteristics, laboratory parameters, nursing-assessed nutritional risk scores, and HLA-DMB gene expression levels were systematically collected through standardized case report forms. Binary logistic regression identified independent predictors, while ROC curve analysis was employed to construct a combinatorial prediction model.

In patients with sepsis, HLA-DMB gene expression levels were significantly lower, while NRS-2002 scores were higher; both were independent predictors of sepsis (p < 0.001). Restricted cubic spline analysis indicated that higher HLA-DMB levels might reduce the risk of sepsis, whereas lower NRS-2002 scores were associated with an increased risk. Furthermore, receiver operating characteristic curve analysis demonstrated that the combined predictive efficacy of HLA-DMB expression and NRS-2002 scores surpassed that of either variable alone (AUC = 0.8430).

HLA-DMB gene expression levels and NRS-2002 scores have been utilized to assess the risk of developing sepsis. Their combined evaluation has enhanced predictive accuracy, facilitating the rational allocation of medical resources in the early stages.