肝脓肿患者败血症的临床特征和风险因素

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-09-30 Epub Date: 2024-09-13 DOI:10.12968/hmed.2024.0206
Kai Wang, Wei Guo, Jihong Zhu, Yang Guo, Weibo Gao
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引用次数: 0

摘要

目的/背景 肝脓肿(LA)是一种严重的内科疾病,患者易患败血症。然而,预测肝脓肿患者败血症的方法却鲜有研究。本研究采用单变量和多变量逻辑回归分析来确定脓毒症的独立风险因素,从而为临床诊断和治疗提供指导。方法 收集了2016年1月1日至2022年10月31日在北京大学人民医院接受治疗的122例LA患者。其中脓毒症患者35例(脓毒症组),其余87例无脓毒症(非脓毒症组)。收集了所有入选病例的临床数据。进行了单变量分析以确定潜在的预测因素,并在多变量逻辑分析中对这些因素进行了检验,以确定洛杉矶病人脓毒症的独立风险因素;利用这些结果建立了一个预测模型。利用接收者操作特征曲线(ROC)来评估预测模型的诊断效果。研究获得了患者或其亲属的知情同意。结果 败血症组的颤抖发生率明显高于非败血症组(P < 0.05)。通过单变量分析发现,败血症组的血小板计数和凝血酶原时间活性降低,糖化血红蛋白(HbAlc)和降钙素原(PCT)升高,均比非败血症组明显(P < 0.05)。多变量逻辑回归分析显示,PCT 和 HbAlc 是衍生队列中 LA 患者脓毒症的独立风险预测因子(P < 0.05)。结论 HbAlc 和 PCT 水平升高是 LA 相关脓毒症的独立风险因素。PCT水平升高的LA患者脓毒症易感性增加21%,HbAlc水平升高的患者脓毒症风险增加38%。
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Clinical Characteristics and Risk Factors of Sepsis in Patients with Liver Abscess.

Aims/Background Liver abscess (LA) is a serious medical condition that predisposes patients to sepsis. However, predicting sepsis in LA patients has rarely been explored. This study employed univariate and multivariate logistic regression analyses to identify independent risk factors for sepsis, which would provide guidance for clinical diagnosis and treatment. Methods A total of 122 patients with LA treated in Peking University People's Hospital from 1 January 2016 to 31 October 2022 were recruited. Among the cases, 35 patients had sepsis (sepsis group) while the remaining 87 did not have sepsis (non-sepsis group). Clinical data were collected for all enrolled cases. Univariate analysis was performed to identify potential predictors, which were tested in multivariable logistic analysis to pinpoint the independent risk factors for sepsis in LA patients; these findings were utilized to develop a prediction model. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of the prediction model. Informed consent to participate was obtained from the patients or their relatives. Results The incidence of shivering in the sepsis group was significantly higher than that in the non-sepsis group (p < 0.05). Through the univariate analysis, it was found that the reduction in platelet count and prothrombin time activity and the elevation of glycosylated hemoglobin (HbAlc) and procalcitonin (PCT) were more significant in the sepsis group than in the non-sepsis group (p < 0.05). Multivariate logistic regression analysis revealed that PCT and HbAlc were independent risk predictors of sepsis in LA patients within the derivation cohort (p < 0.05). Conclusion Elevated levels of HbAlc and PCT were independent risk factors for sepsis associated with LA. Patients with LA exhibiting elevated PCT levels demonstrated a 21% increased susceptibility to sepsis, and those with elevated HbAlc levels showed a 38% heightened risk for sepsis.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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