| Objective: To observe the correlation between D-dimer,interleukin-6,Acute Physiology and Chronic Health Score(APACHE)Ⅱ score and sepsis and their role in prognostic evaluation.Methods: A retrospective case analysis was adopted to screen patients with sepsis admitted to the Department of Intensive Care Medicine(ICU)of the Affiliated Hospital of Yanbian University from January 1,2017 to October 1,2020,and to exclude patients with malignant tumors and hematological correlations.After diseases,immune-related diseases and other cases,144 patients with sepsis were finally selected.The selected patients were collected on the same day before the treatment of basic vital signs,renal function,electrolytes,blood gas analysis,blood routine,D-dimer,PCT,CRP and blood test parameter calculation values and other indicators,and calculated based on the patient’s age and past medical history APACHEⅡ score.The selected patients were divided into the death group and the survival group according to their survival within 28 days after admission,and were divided into the septic shock group and the septic non-shock group according to whether they had shock at the time of admission.Collect the gender,age,ethnicity,and length of stay in each group of patients.SPSS26.0 software was used to analyze the data,and the results were statistically significant with P<0.05.The outcome of sepsis and the influencing factors of shock were analyzed by logistic regression,and the predictive value of death was analyzed by ROC curve.Results: sepsis survival group and the death group,and the difference was not statistically significant(P>0.05);the IL-6 and D-dimer of the sepsis survival group and the death group,CRP,PCT,CRP/ALB,APACHEⅡ scores were higher in the sepsis death group than in the survival group,and the difference was statistically significant(P<0.05).There was no statistical difference in WBC,PLT,ALB,MPV between the death group and the survival group Significance(P>0.05);the generalized linear model analysis of sepsis death factors are IL-6,CRP,DD,CRP/ALB with correlation IL-6 and CRP/ALB(95%CI: 0.578-0.756);ROC curve analysis IL-6,the area under the CRP/ALB curve is 0.667,the sensitivity of IL-6 is78.12,the specificity is 50.0,and the critical value is 19.46.The area under the D-dimer curve is 0.622,the sensitivity is 100,and the critical value is 656.69.CRP/ALB has a sensitivity of 64.06 and a specificity of 68.75.The area under the APACHE Ⅱ curve is 0.872,the sensitivity is 93.75,the specificity is 67.50,the area under the combined IL-6+D-D+APACHE Ⅱ scoring curve is 0.885,and the sensitivity is 98.44.This combined area is the largest and best reflects the correlation with prognosis.Logistic regression analysis of independent factors affecting the risk of death from sepsis are IL-6,CRP/ALB,APACHE Ⅱ score(OR>1);the factors affecting septic shock are IL-6,CRP,PCT,CRP/ ALB.There is a correlation between ALB and NLR.The area under the curve of IL-6 in single factor analysis is 0.702,the sensitivity is 80.95,and the specificity is 53.09.The area under the PCT curve is0.679,the sensitivity is 47.62,and the specificity is 80.25.The area under the NLR curve is 0.598,the sensitivity is 50.79,and the specificity is 71.60.Conclusion:1.The independent influencing factors of sepsis death risk are IL-6,CRP/ALB,APACHE Ⅱ score;2.The influencing factors of septic shock are IL-6,CRP,PCT,CRP/ALB,NLR;3.IL-6,D-D,CRP/ALB,PCT,CRP,APACHE Ⅱ scores are risk-related factors for the prognosis of sepsis.When IL-6 and PCT,CRP,APACHE Ⅱ scores increase,death.The risk will increase.4.The combination of IL-6,D-D and APACHEⅡ score has guiding signific ance in predicting the prognosis of sepsis. |
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