The Clinical Research Of Identifying Hemorrhagic Shock And Septic Shock By The Difference Of Hematocrit And Serum Albumin

Object:To investigate the feasibility of identifying hemorrhagic shock and septic shock by the difference of hematocrit and serum albuminMethod:The first part(group A)385healthy volunteers from medical examination center, First affiliated Hospital of Kunming medical University aged20-75yr,185males and200females, were selected. The second part (group B):46cases with hemorrhagic shock treated at intensive care unit of First affiliated Hospital of Kunming medical University from November2011to March2013, aged18-86yr,23males and23females were selected.The third part (group C):76septic shock patients, treated at Department of intensive care unit,First affiliated Hospital Kunming University from December2011to November2012, aged5-93yr, including48males and26females were selected. The Hct and serum Alb of patients’ venous blood from group B and group C was detected when they went to ICU within an hour.We made the receiver operating characteristic (ROC) to analysis the difference of Hct and serum Alb threshold to discriminate between hemorrhagic shock and septic shock, the area under the curve(AUC) for the difference of Hct and serum Alb and sensitivity and specificity were calculated.Results:There was no significant difference in age and the ratio of F/M. The difference of Hct and serum Alb were slightly higher in group B than in group A (p>0.05),and it was significantly higher in group C(p<0.05). Compared with group B patients’Hct-Alb of group C was significantly higher (p<0.05).Receiver operating characteristic (ROC) curves were generated for the difference of Hct and serum Alb and areas under the ROC curves were calculated. The areas under the ROC curves were0.918for SVV.The optimal threshold value of the difference of Hct and serum Alb to discriminate between hemorrhagic shock and septic shock was9.15(sensitivity:90.5%; specificity:87%).Conclusion:we found that the difference of hematocrit and serum albumin was able to identify the patients with hemorrhagic shock and septic shock with acceptable levels of sensitivity and specificity.