The Clinical Significance Of Pulse Infusion Index Monitoring In The Assessment Of Disease And Prognosis In Patients With Septic Shock

Objective:To investigate the clinical significance of pulse infusion index?PI?monitoring in assessing the condition of patients with septic shock and the predictive value of the prognosis of patients with septic shock,so as to provide a certain clinical guidance value for the diagnosis and treatment of septic shock patients.Methods:Through prospective observational studies,patients diagnosed with EICU from January 2017 to February 2018 were clearly diagnosed as sepsis?n=36?and Patients with septic shock?n=36?were the study subjects.They collected biological information of the patients,biomarker test results within 24 hours after admission,PI values,SOFA score results,APACHE II score results,and 28-day prognosis,and were divided into sepsis and septic shock groups,survival and death groups,statistical analysis was performed using IBM SPSS Statistics 19.0 and MedCalc statistical software.A descriptive analysis of baseline data was performed.Measured data with normal distribution were expressed as mean±standard deviation??x±s?.Quantitative indicators of non-normal distribution were expressed as median,minimum,and maximum;The data were expressed in terms of rate and component ratios.?² test was used for comparison;t-test was used for comparison between the two groups;logistic regression analysis was used to identify factors that could independently predict the patient's 28-day prognosis,and the ROC curve was used to compare the predictive power of various factors and calculate The corresponding cut-off values were obtained;Pearson correlation analysis was performed between PI and related clinical indicators;both were statistically significant when P<0.05.Results:1.There was no significant difference in age,sex,Hb,ALB,WBC,N%,24h fluid output,length of stay between sepsis group and septic shock group?P>0.05?;MAP and PI value,SPO₂,oxygenation index,Lac,CRP,PCT,D-Dimer,PLT,ALT,AST,TBIL,CREA,BUN,SOFA score,APACHE II score,24h fluid intake were statistically different between the two groups?P<0.05?.2.Multivariate logistic regression analysis showed that PI value,SOFA score,and APACHE II score were independent risk factors for 28-day prognosis in patients with septic shock?P<0.05?.3.The results of ROC curve analysis of independent risk factors for death in patients with septic shock showed that the PI value predicted 28-day mortality risk with a lower bound of 0.5,AUC was 0.732?95%CI:0.552 to 0.911,P=0.019?,and the sensitivity was 85.7%,specificity 53.3%;SOFA score predicts a 28-day mortality risk upper limit of 10,AUC 0.832?95%CI:0.701 to 0.963,P=0.001?,sensitivity86.7%,specificity 42.9%;APACHE II score prediction The 28-day death risk had an upper limit of 26,AUC was 0.938?95%CI:0.858 to 1.000,P<0.001?,sensitivity was93.3%,and specificity was 38.1%.4.Independent death risk factors in patients with septic shock The 28-day mortality risk comparison results showed that the PI value was less predictive than the APACHE II score?Z=2.099,P=0.036?,and the PI value was comparable to the SOFA score prediction ability?Z=0.899,P=0.369?,SOFA score were comparable to the APACHE II score?Z=1.744,P=0.081?.5.Pearson correlation analysis showed that PI value was negatively correlated with SOFA score?r=-0.373,P=0.025?,PI value was negatively correlated with APACHE II score?r=-0.368,P=0.027?,SOFA score and APACHE II score was positive correlation?r=1,P<0.001?.Conclusions:1.The PI value can be used as an independent predictor of 28-day risk of death in septic shock patients,predicting a 28-day mortality risk threshold for patients with septic shock as 0.5.2.The SOFA score and APACHE II score were used as independent predictors of28-day risk of death in septic shock patients,respectively.The cut-off value for28-day mortality risk in patients with septic shock was predicted to be 10,26,respectively.3.Independent death risk factors the comparison of the 28-day mortality risk of septic shock patients showed that the PI value was weaker than the APACHE II score prediction ability,the PI value was comparable to the SOFA score prediction ability,and the SOFA score was comparable to the APACHE II score prediction ability.