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[Assessment values of procalcitonin, lactic acid, and disease severity scores in patients with sepsis].
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019 Aug; 31(8):938-941.ZW

Abstract

OBJECTIVE

To investigate the assessment values of procalcitonin (PCT), lactic acid (LAC), sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation II (APACHE II) score in patients with sepsis.

METHODS

140 patients with suspicious bacterial infection admitted to emergency department of Beijing Chaoyang Hospital of the Capital Medical University from August 2017 to June 2018 were enrolled. They were divided into three groups according to diagnostic criteria of Sepsis-3: non-sepsis group (n = 58), sepsis group (n = 66) and septic shock group (n = 16). The PCT, LAC, SOFA score, APACHE II score, 28-day prognosis, and positive detection rate of PCT and LAC were compared among three groups. Independent predictors of 28-day mortality were analyzed by Logistic regression; predictive values of PCT, LAC, SOFA score and APACHE II score for 28-day mortality in sepsis patients were analyzed by receiver operating characteristic (ROC) curve.

RESULTS

PCT, LAC, SOFA score, APACHE II score at admission, and 28-day mortality in sepsis group and septic shock group were significantly higher than those in non-sepsis group, and PCT, LAC, APACHE II score, and 28-day mortality in sepsis shock group were further higher than those in sepsis group [PCT (μg/L): 38.1±12.6 vs. 4.6±2.3, LAC (mmol/L): 3.3±2.1 vs. 2.4±2.1, APACHE II score: 14.9±2.4 vs. 9.5±4.3, 28-day mortality: 75.0% vs. 24.2%, all P < 0.05]. The positive detection rate of PCT and LAC in sepsis group and septic shock group were higher than those in non-sepsis group (positive detection rate of PCT: 56.1%, 81.3% vs. 32.8%; positive detection rate of LAC: 42.4%, 62.5% vs. 13.7%; all P < 0.01). Logistic regression analysis showed that PCT, LAC, SOFA score and APACHE II score were independent predictors of 28-day mortality [PCT: odds ratio (OR) = 0.933, 95% confidence interval (95%CI) = 0.878-0.991; LAC: OR = 0.539, 95%CI = 0.347-0.838; SOFA score: OR = 0.291, 95%CI = 0.514-0.741; APACHE II score: OR = 0.808, 95%CI = 0.669-0.976; all P < 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) of PCT, LAC, SOFA score and APACHE II score predicting 28-day mortality was 0.76, 0.86, 0.81 and 0.87, respectively. The assessment values of APACHE II score and LAC were higher than PCT in predicting 28-day mortality (Z1 = 2.56, Z2 = 2.45, both P < 0.01), and the performance of SOFA score was similar to PCT.

CONCLUSIONS

PCT, LAC, SOFA score and APACHE II score were reliable indexes to evaluate disease severity for patients diagnosed with infection. The assessment values of APACHE II score and LAC in 28-day mortality were superior to SOFA score and PCT.

Authors+Show Affiliations

Department of Emergency, Beijing Chaoyang Hospital of the Capital Medical University, Beijing 100020, China. Corresponding author: Guo Shubin, Email: shubinguo@126.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

chi

PubMed ID

31537215

Citation

Wang, Junyu, et al. "[Assessment Values of Procalcitonin, Lactic Acid, and Disease Severity Scores in Patients With Sepsis]." Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, vol. 31, no. 8, 2019, pp. 938-941.
Wang J, Wang H, Liu W, et al. [Assessment values of procalcitonin, lactic acid, and disease severity scores in patients with sepsis]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019;31(8):938-941.
Wang, J., Wang, H., Liu, W., Zhang, D., & Guo, S. (2019). [Assessment values of procalcitonin, lactic acid, and disease severity scores in patients with sepsis]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 31(8), 938-941. https://doi.org/10.3760/cma.j.issn.2095-4352.2019.08.005
Wang J, et al. [Assessment Values of Procalcitonin, Lactic Acid, and Disease Severity Scores in Patients With Sepsis]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019;31(8):938-941. PubMed PMID: 31537215.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Assessment values of procalcitonin, lactic acid, and disease severity scores in patients with sepsis]. AU - Wang,Junyu, AU - Wang,Hongwei, AU - Liu,Wenxin, AU - Zhang,Da, AU - Guo,Shubin, PY - 2019/9/21/entrez PY - 2019/9/21/pubmed PY - 2019/10/18/medline SP - 938 EP - 941 JF - Zhonghua wei zhong bing ji jiu yi xue JO - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue VL - 31 IS - 8 N2 - OBJECTIVE: To investigate the assessment values of procalcitonin (PCT), lactic acid (LAC), sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation II (APACHE II) score in patients with sepsis. METHODS: 140 patients with suspicious bacterial infection admitted to emergency department of Beijing Chaoyang Hospital of the Capital Medical University from August 2017 to June 2018 were enrolled. They were divided into three groups according to diagnostic criteria of Sepsis-3: non-sepsis group (n = 58), sepsis group (n = 66) and septic shock group (n = 16). The PCT, LAC, SOFA score, APACHE II score, 28-day prognosis, and positive detection rate of PCT and LAC were compared among three groups. Independent predictors of 28-day mortality were analyzed by Logistic regression; predictive values of PCT, LAC, SOFA score and APACHE II score for 28-day mortality in sepsis patients were analyzed by receiver operating characteristic (ROC) curve. RESULTS: PCT, LAC, SOFA score, APACHE II score at admission, and 28-day mortality in sepsis group and septic shock group were significantly higher than those in non-sepsis group, and PCT, LAC, APACHE II score, and 28-day mortality in sepsis shock group were further higher than those in sepsis group [PCT (μg/L): 38.1±12.6 vs. 4.6±2.3, LAC (mmol/L): 3.3±2.1 vs. 2.4±2.1, APACHE II score: 14.9±2.4 vs. 9.5±4.3, 28-day mortality: 75.0% vs. 24.2%, all P < 0.05]. The positive detection rate of PCT and LAC in sepsis group and septic shock group were higher than those in non-sepsis group (positive detection rate of PCT: 56.1%, 81.3% vs. 32.8%; positive detection rate of LAC: 42.4%, 62.5% vs. 13.7%; all P < 0.01). Logistic regression analysis showed that PCT, LAC, SOFA score and APACHE II score were independent predictors of 28-day mortality [PCT: odds ratio (OR) = 0.933, 95% confidence interval (95%CI) = 0.878-0.991; LAC: OR = 0.539, 95%CI = 0.347-0.838; SOFA score: OR = 0.291, 95%CI = 0.514-0.741; APACHE II score: OR = 0.808, 95%CI = 0.669-0.976; all P < 0.05]. ROC curve analysis showed that the area under ROC curve (AUC) of PCT, LAC, SOFA score and APACHE II score predicting 28-day mortality was 0.76, 0.86, 0.81 and 0.87, respectively. The assessment values of APACHE II score and LAC were higher than PCT in predicting 28-day mortality (Z1 = 2.56, Z2 = 2.45, both P < 0.01), and the performance of SOFA score was similar to PCT. CONCLUSIONS: PCT, LAC, SOFA score and APACHE II score were reliable indexes to evaluate disease severity for patients diagnosed with infection. The assessment values of APACHE II score and LAC in 28-day mortality were superior to SOFA score and PCT. SN - 2095-4352 UR - https://www.unboundmedicine.com/medline/citation/31537215/[Assessment_values_of_procalcitonin_lactic_acid_and_disease_severity_scores_in_patients_with_sepsis]_ L2 - https://medlineplus.gov/sepsis.html DB - PRIME DP - Unbound Medicine ER -