Clinical Value Of Prealbumin In Patients With Sepsis And Its Relationship With Prognosis

Objective: To investigate the value of serum prealbumin in the severity of sepsis patients by collecting the data of 77 patients with sepsis.Methods: 77 patients with sepsis who were enrolled in the First Affiliated Hospital of Jinan University from January 1,2020 to December 31,2020 were retrospectively studied.All the patients met the diagnostic criteria of sepsis-3,the definition of sepsis released in 2016,had complete medical records and treatment procedures,and had been in the ICU for more than 72 hours.We set up strict inclusion and exclusion criteria.According to the serum prealbumin concentration measured within 24 hours after admission,they were divided into three groups: group A(serum prealbumin≥200mg/L),group B(serum prealbumin 100-200mg/L)serum prealbumin slightly decreased,and group C(serum prealbumin <100mg/L),serum prealbumin severely decreased.Meanwhile,the patients were divided into survival group and death group according to the outcome of this treatment in hospital.Then we statistically analyzed the influence of different serum prealbumin concentrations on the severity of the disease and the development outcome of patients.Results: 1.Baseline data analysis: There was no significant difference in gender,age,basic diseases,infected disease type and other baseline characteristics between patients with normal serum prealbumin and patients with reduced serum prealbumin(P>0.05).2.There were statistically significant differences in APACHE II score,SOFA score,serum CRP,case fatality rate,ICU hospitalization days and duration of antibiotic use among patients in group A,B and C(P<0.05).In pair comparison,LSD post-mortem test showed that: in this study,group B and group A only had statistical significance in the length of ICU stay,duration of antibiotic use and case fatality rate(P<0.05);APACHE II score,SOFA score,serum CRP,case fatality rate,length of stay in ICU and duration of antibiotic use were statistically significant between group C and group A(P<0.05).3.The serum prealbumin concentration was negatively correlated with APACHEⅡ score,SOFA score,CRP,length of stay in ICU and duration of antibiotic use,with statistical significance(P<0.01).4.There were statistically significant differences between the survival group and the death group in the comparison of serum pre-albumin,albumin,platelet and SOFA scores between the two groups(P < 0.05).5.The ROC curve for predicting mortality indicated that the threshold value of serum prealbumin concentration for predicting mortality was 81.05mg/L,the sensitivity was 83.3%,the specificity was 76.5%,and the area under the ROC curve was 0.837(95%CI: 0.723-0.952).The cutoff value of SOFA score for predicting death was 13.5 points,the sensitivity was 70.6%,the specificity was 63.3%,and the area under the curve was 0.738(95%CI: 0.606-0.870),all of which had statistical significance(P<0.05).Conclusion: 1.Detection of serum prealbumin concentration has certain reference value in predicting the length of stay in ICU,duration of antibiotic use and final outcome of patients,and its predictive effect is higher than SOFA score;2.When serum prealbumin level was less than 81.05mg/L,the clinical outcome was worse.2.The serum prealbumin concentration was negatively correlated with APACHEⅡ score,SOFA score,CRP,length of ICU stay and duration of antibiotic use.