Clinical Manifestations And Related Biomarkers In Patients With Sepsis Clinical Value Of Prognosis

Objective:To understand the correlation between clinical symptoms and related biomarkers and condition and prognosis in patients with sepsis.Methods:A retrospective case-control study was conducted on 288 patients with sepsis who were treated in the first affiliated Hospital of Xinjiang Medical University from November 2018 to December2019.They were divided into sepsis group(n=201)and septic shock group(n=87).With 28 days as the node,they were divided into survival group and death group.The differences of general data and laboratory indexes between the two groups were compared.The factors with statistical differences were included in Cox univariate and multivariate regression analysis,and the subjects’working curve(Receiver Operating Characteristic,ROC) and Kmuri M survival analysis were drawn.Results:the fatality rate of 288 patients with sepsis was 24.65%.Univariate analysis showed that sex,age,admission temperature,Plt,Lac,Alb,PCT and IL-6 were important factors affecting the survival of patients with sepsis.Further Cox multivariate analysis showed that age,body temperature,platelet,lactic acid and albumin affected the prognosis of patients,in which admission temperature,Lac,PCT were positively correlated with prognosis,while Alb and PLT were negatively correlated.It is concluded that the area under the ROC curve(AUC),body temperature+lactic acid+procalcitonin has the highest prognostic value of0.907,with a sensitivity of 83.10%and a specificity of 83.40%.Kmurm survival curve:there was significant difference between the low level group(<38℃)and the high level group(>38℃)(χ~2=89.298,P<0.0001).There was significant difference in Plt between the low level group(<130*10~9/L)and the high level group(>130*10~9/L)(χ~2=25.873,P<0.0001).There was significant difference between low level Lac group(<4 mmol/L)and high level group(>4 mmol/L)(χ~2=19.389,P<0.0001).There was significant difference between low level Alb group(<30g/L)and high level group(>30g/L)(χ~2=17.017,P<0.0001).There was significant difference between low level PCT group(<2 ng/ml)and high level group(>2 ng/ml)(χ~2=45.931,P<0.0001).Further blood culture results:a total of 97 strains of pathogenic bacteria were isolated from 212 patients,including 63 strains of Gram-negative bacteria(64.95%),31 strains of Gram-positive bacteria(31.96%),3 strains of fungi(3.09%)and 34 strains of Escherichia coli(53.97%).Conclusions the main clinical feature is fever,and body temperature,lactic acid,procalcitonin,platelet and albumin are closely related to the condition and prognosis of the patients.