Abstract (
)
Download PDF (
)
Knowledge map
Save
Objective:To explore the relationship between percent change of serum procalcitonin and arterial lactate and the 28-day outcome of patients with septic shock.Methods:From January 2016 to February 2018, patients with septic shock who were admitted to the ICU of Fuxing Hospital affiliated to Capital Medical University and survived for at least 48 hours were included.Study endpoint was patient outcome 28 days after admission.The patients survived the 28-day period (cured,under treatment,discharged or transferred to other ward) were assigned to survivor group.The patients who died in the 28-day period were assigned to the dead group Clinical details were collected from all patients,including acute physiology and chronic health evaluation(APACHE Ⅱ)score in the first 24 hours in ICU, primary diagnosis,arterial lactic acid(LAC0h)and calcitonin level (PCT0h) before treatment.After 24-and 48-hour treatment,lactate and procalcitonin levels (LAC24h,LAC48h,PCT24h,PCT48h)were retested.The percent change of LAC and PCT were calculated at 24h and in 48h:LAC0-24h,LAC0-48h,PCT0-24h,and PCT0-48h.The two groups of patients were compared in terms of relevant parameters,including APACHE Ⅱ score,LAC0-24h,LAC0-48h,PCT0-24h,and PCT0-48h.Logistic regression was used to analyze the effect of LAC0-24h,LAC0-48h,PCT0-24h,and PCT0-48h on patient outcome.ROC curve was plotted to observe the prognostic value of the percent change of serum PCT and arterial lactate at 24 and 48 hours(LAC0-24h,LAC0-48h,PCT0-24h,PCT0-48h)in patients with septic shock.Results:The eligible patients were divided into survivor group(53 cases)or death group(52 cases)based on the survival status 28 days after admission to ICU. The patients in the two groups did not show significant difference in sex,age,primary site of infection,and APACHE Ⅱ score.LAC0-24h,LAC0-48h,PCT0-24h,and PCT0-48h were significantly different between the two groups.LAC0-24h,LAC0-48h,PCT0-24h,and PCT0-48h were taken as independent variables,and the survival or death were taken as dependent variables to conduct logistic regression analysis.Logistic regression equation was fitted using LAC0-48h and PCT0-48h.For LAC0-48h,the regression coefficient was 3.966, Wald value was 12.709,and P＜0.001.For PCT0-48h, the regression coefficient was 3.197,Wald value was 11.651 and P=0.001.PCT0-48h in combination with LAC0-48h showed higher predictive value for adverse outcome.The area under the ROC curve was 0.961 for LAC0-48h+PCT0-48h combination.The corresponding sensitivity was 90.4% and specificity was 91.6%.Conclusions:LAC0-48h in combination with PCT0-48h could be used as a simple and effective indicator for predicting the outcome of patients with septic shock.
