败血症弥散性血管内凝血病的预测模型:一项观察性研究

IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of General Medicine Pub Date : 2024-10-22 eCollection Date: 2024-01-01 DOI:10.2147/IJGM.S475953
Yaojie Fu, Yujing He, Caixia Zheng, Jianyong Zeng, Hongjie Ou
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引用次数: 0

摘要

导言:由于发病率和死亡率高,败血症仍然是全球健康面临的重大挑战。弥散性血管内凝血病(DIC)是败血症的一个重要并发症,会增加死亡率和经济负担。尽管有各种预后评分系统,但目前还缺乏预测败血症患者 DIC 的特定模型:这项观察性研究包括 336 名败血症患者。方法:这项观察性研究纳入了 336 名脓毒症患者,收集了临床和实验室数据,并根据既定标准确定了预后:我们招募了 336 名患者,其中非 DIC 组 304 人,DIC 组 32 人。与非 DIC 患者相比,DIC 患者的血小板(PLT)明显较低,凝血酶原时间(PT)、乳酸(LAC)和降钙素原(PCT)水平较高。单变量和多变量分析确定了与 DIC 相关的风险因素,结果显示 PLT(OR = 0.985,95% CI 0.978-0.993,p < 0.001)、PT 水平(OR = 1.140,95% CI 1.004-1.295,p = 0.044)和 LAC(OR = 1.101,95% CI 0.989-1.226,p = 0.078)是相关因素。通过与 SOFA 评分比较,建立了风险模型,并评估了该模型预测脓毒症患者 DIC 的敏感性和特异性。该模型的 ROC 曲线下面积为 0.850,而 SOFA 评分为 0.813。当模型得分大于 2.12 时,预测 DIC 的灵敏度为 84.4%,特异度为 75.0%:我们的研究为脓毒症患者的 DIC 检测引入了一个预测模型,强调临床医生需要关注模型得分高的患者,以便及时干预。
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A Predictive Model for Disseminated Intravascular Coagulopathy in Sepsis: An Observational Study.

Introduction: Sepsis remains a significant global health challenge due to its high morbidity and mortality rates. Disseminated Intravascular Coagulopathy (DIC) represents a critical complication of sepsis, contributing to increased mortality and economic burden. Despite various prognostic scoring systems, there is a lack of a specific model for DIC prediction in sepsis patients.

Methods: This observational study included 336 sepsis patients. Clinical and laboratory data were collected, and prognoses were defined according to established criteria.

Results: We enrolled 336 patients, with 304 in the non-DIC group and 32 in the DIC group. Patients with DIC had notably lower platelet (PLT) and higher levels of prothrombin time (PT), lactate (LAC), and procalcitonin (PCT) compared to those without DIC. Univariate and multivariate analyses identified risk factors associated with the DIC, showing that PLT (OR = 0.985, 95% CI 0.978-0.993, p < 0.001), PT level (OR = 1.140, 95% CI 1.004-1.295, p = 0.044), and LAC (OR = 1.101, 95% CI 0.989-1.226, p = 0.078) were related factors. A risk model was established, and its sensitivity and specificity in predicting DIC among sepsis patients were assessed by comparing it to the SOFA score. The area under the ROC curve for the model was 0.850, while the SOFA score was 0.813. With a model score >-2.12, the sensitivity for predicting DIC was 84.4%, and the specificity was 75.0%.

Conclusion: Our study introduces a predictive model for DIC detection in sepsis patients, emphasizing the need for clinicians to focus on patients with high model scores for timely intervention.

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来源期刊
International Journal of General Medicine
International Journal of General Medicine Medicine-General Medicine
自引率
0.00%
发文量
1113
审稿时长
16 weeks
期刊介绍: The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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