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使用时间作为一个重要的因素来准确预测疑似败血症患者的败血症相关死亡率
Shih-Chieh Yen1, Chin-Chieh Wu1, Yi-Ju Tseng2
1Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
Biomedical journal
|July 19, 2023
概括
生物标志物动态影响败血症预测. 干白素-6 (IL-6),素-3和sCD163在早期表现出色,而顺序器官衰竭评估 (SOFA) 评分仍然是一致的预测.
科学领域:
- 临床医学 临床医学
- 生物标志物 生物标志物
- 败血症研究 败血症研究
背景情况:
- 由于随着时间的推移动态生物标志物变化,败血症结果的预测具有挑战性.
- 静态生物标志物测量通常无法准确预测患者的预后.
- 需要进行前性研究来评估不同疾病持续时间的多种生物标志物.
研究的目的:
- 评估传统和新型败血症生物标志物对死亡率的预测性能.
- 为了比较疾病过程中不同时间点的生物标志物疗效.
- 为早期和持续性败血症预测确定最佳生物标志物.
主要方法:
- 对疑似败血症患者的前性队列研究.
- 对15种新生物标志物 (例如IL-6,素3,sCD163) 和常规标志物的评估.
- 使用接收器操作特征 (ROC) 曲线分析生物标志物性能,按症状发作后的几天分层.
主要成果:
- 包括1483名患者;死亡率为3.3%. 高发病率的SIRS (78%) 和败血症-3 (62%) 标准.
- 在早期疾病中,IL-6,素3,sCD163和血液气体概况显示出高预测精度 (AUROC 0.81-0.88).
- 顺序性器官衰竭评估 (SOFA) 评分在整个疾病过程中显示出一致的预测性表现 (AUROC 0.70-0.91).
结论:
- IL-6,素3,sCD163和血液气体概况是败血症相关死亡率的早期预测指标.
- SOFA评分提供了随着时间的推移对败血症死亡率的一致和可接受的预测.
- 了解生物标志物动态对于准确的败血症预后至关重要.
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