| Objective:To explore the application value of prognostic nutritional index(PNI)and systemic immune-inflammation index(SII)in the evaluation and prognosis of patients with sepsis.Methods:The clinical data of 112 sepsis patients admitted to the Internal Medicine ICU of the Affiliated Hospital of Guizhou Medical University from October 2019 to October 2021 were retrospectively analyzed.The patients were divided into sepsis group and septic shock group according to the severity of their condition.The age,gender,and related blood indexes within 24 hours of admission were recorded,such as neutrophil count(NEUT),platelet count(PLT),lymphocyte count(LYMPH),albumin(ALB),procalcitonin(PCT)and other clinical indicators.PNI,SII,acute physiology and chronic health(APACHE Ⅱ)score and sequential organ failure(SOFA)score within 24 hours of admission were calculated respectively.All patients were divided into survival group and death group according to their 28-day outcomes.Statistical methods were used for between-group analysis.Pearson correlation was used to analyze the correlation between the indicators.Binary logistic regression was used to analyze independent risk factors.Receiver operating(ROC)curve was drawn to analyze the diagnostic efficacy,P<0.05 indicated a statistical difference,and P<0.001 indicated a significant statistical difference.Results:(1)The 28-day mortality rates in the sepsis group and septic shock group were 20.37%and 55.17%,respectively,and the difference was statistically significant(P<0.001);(2)PNI and ALB in the sepsis group were higher than those in the septic shock group.Group[(35.61 ±4.83)vs(31.67±5.47),(30.97±3.94)g/L vs(27.34±4.68)g/L],the difference was statistically significant(both P<0.001);sepsis group SII,APACHE Ⅱ score,SOFA score and NEUT were lower than those in the septic shock group[(677.39(1113))vs(2022.21(2118)),(17.76±5.11)vs(24.57±4.64),(7.19±2.73)(11.45±2.43)points,(9.05±6.00)109/L vs(14.68±7.48)109/L],the difference was statistically significant(all P<0.001);(3)PNI,ALB,LYMPH was higher than the death group[(36.05±5.52)vs(29.58±4.03),(30.80±4.38)g/L ratio(26.34±3.79)g/L,(1.05±0.54)109/L ratio(0.65±0.37)109/L],the difference was statistically significant(all P<0.001).The SII,APACHE Ⅱ score,SOFA score and NEUT of the survival group were lower than those of the death group[(668.89(971))vs(2485.04(1521)),(18.45±4.80)vs(25.84±4.62),(7.83±2.86)(11.91±2.40)points,(10.09±7.32)109/L versus(14.98±6.37)109/L],the difference was statistically significant(all P<0.001);(4)PNI was negatively correlated with APACHE Ⅱ score and SOFA score(correlation coefficients were-0.472 and-0.398,P<0.001);SII was positively correlated with APACHE Ⅱ score and SOFA score(correlation coefficients were 0.469,0.386,P<0.001).(5)PNI,LYMPH,APACHE Ⅱ score,and SOFA score were related to the prognosis of sepsis.The area under the curve of PNI was 0.846,the sensitivity was 0.797,and the specificity was 0.814;the area under the curve of PNI combined with SOFA score was 0.924,the sensitivity was 0.942,and the specificity was 0.767.Conclusions:(1)Patients with sepsis and septic shock are accompanied by abnormal PNI and SII,It is manifested as a decrease in PNI and an increase in SII with the severity of the disease;(2)PNI and SII may be closely related to the severity of sepsis;(3)PNI affects the severity of sepsis.It is an independent risk factor for the prognosis of sepsis;PNI combined with SOFA score has a good clinical application value for the prognosis evaluation of patients with sepsisl. |
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