Literature DB >> 35355798

Complete Blood Count and Myocardial Markers Combination with Sequential Organ Failure Assessment Score Can Effectively Predict the Mortality in Sepsis: A Derivation and Validation Study.

An Zhang1, Pengfei Wang1, Keli Wen1, Hu Du1, Binfei Tang1, Bin Xiong1.   

Abstract

Purpose: The purpose of our study was to explore the prognostic value of complete blood count and myocardial markers combination with Sequential Organ Failure Assessment (SOFA) score in predicting the 28-day mortality among sepsis patients. Patients and methods: A retrospective observational cohort study was performed. Three hundred and nineteen sepsis patients who were hospitalized at the Second Affiliated Hospital of Chongqing Medical University, China, from January 2019 to September 2021 were included. The clinical and laboratory data, the Acute Physiological and Chronic Health Evaluation II (APACHE II) score and SOFA score at the time of the initial sepsis diagnosis were collected, and the predictive values of the single and combination variables for 28-day mortality were compared.
Results: The derivation cohort consisted of 221 patients and included 59 (26.7%) died. The area under the curve (AUC) [95% confidence interval (CI)] of RDW and cTnT were 0.735 (0.663-0.807) and 0.753 (0.678-0.827) for mortality, and the cut-off value were 14.05% and 0.039 ng/mL, respectively. The combination of RDW, cTnT and the SOFA score showed a better performance for the prediction of mortality, and the AUC was significantly higher than that of the SOFA score (0.791 vs 0.726, DeLong test: P=0.032). Multivariate Cox analysis identified that the combination of RDW, cTnT and the SOFA score (HR=6.133, P=0.004) and APACHE II score (HR=1.093, P<0.001) were independent detrimental factors for 28-day mortality. The validation cohort consisted of 98 patients and included 23 (23.5%) died. Similarly, the AUC of the RDW, cTnT and the SOFA score combination is significantly higher than that of the SOFA score (0.821 vs 0.739, DeLong test: P=0.035).
Conclusion: RDW and cTnT showed good performance in predicting 28-day mortality rates among patients with sepsis. Combined RDW and cTnT with the SOFA score can significantly improve the predictive value of SOFA score for the prognosis of sepsis.
© 2022 Wen et al.

Entities:  

Keywords:  Sequential Organ Failure Assessment score; cardiac troponin T; marker; red blood cell distribution width; sepsis; septic shock

Year:  2022        PMID: 35355798      PMCID: PMC8958200          DOI: 10.2147/IJGM.S349751

Source DB:  PubMed          Journal:  Int J Gen Med        ISSN: 1178-7074


  41 in total

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