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[Prognostic value of Charlson weighted index of comorbidities combined with sequential organ failure assessment score and procalcitonin in patients with sepsis].
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019 Nov; 31(11):1335-1339.ZW

Abstract

OBJECTIVE

To assess the prognostic value of Charlson weighted index of comorbidities (WIC) combined with sequential organ failure assessment (SOFA) score and procalcitonin (PCT) in sepsis patients in intensive care unit (ICU).

METHODS

A prospective cohort study was conducted. 118 patients with sepsis admitted to ICU of Sichuan Provincial People's Hospital from July 2015 to June 2018 were enrolled. The clinical data of the patients including gender, age, pathogenic factors, site of infection, underlying diseases and 28-day prognosis were collected, while the WIC score at ICU admission, the acute physiology and chronic health evaluation II (APACHE II) score and SOFA score within 24 hours after ICU admission, serum PCT level within 1 hour after ICU admission were recorded. The patients were divided into survival group and death group according to 28-day prognosis, and the clinical data of patients with different prognosis were compared. Multivariate Logistic regression model was used to analyze the relationship between WIC score, SOFA score, PCT level and the outcomes of patients. The receiver operating characteristic (ROC) curve was drawn to evaluate the value of WIC score, SOFA score, and PCT level for predicting the prognosis of patients with sepsis.

RESULTS

In this study, 118 eligible sepsis patients were enrolled, and 94 patients survived at 28 days, and 24 patients died with a 28-day mortality of 20.3%. Compared with the survival group, the patients in the death group were older and had higher APACHE II score, WIC score, SOFA score, and serum PCT levels. Pathogenic factors analysis showed that the proportion of pulmonary infection in the death group was the highest (62.5%), while in the survival group the main cause was multiple injury (36.2%), followed by pulmonary infection (30.9%). Basic diseases analysis showed that the proportions of tumor, type 2 diabetes, chronic lung disease, cerebrovascular disease, chronic kidney disease, chronic liver disease, and chronic cardiac insufficiency in the death group were significantly higher than those in the survival group. The age [odds ratio (OR) = 1.279, 95% confidence interval (95%CI) was 1.065-1.536], APACHE II score (OR = 1.255, 95%CI was 1.083-1.455), WIC score (OR = 1.429, 95%CI was 1.304-1.568), SOFA score (OR = 1.331, 95%CI was 1.456-1.545), and serum PCT level (OR = 1.497, 95%CI was 1.146-1.547) were related to the 28-day prognosis of patients with sepsis, and were independent predictors of 28-day prognosis in patients with sepsis (all P < 0.01). ROC curve analysis showed that the area under ROC curve (AUC) of WIC score, SOFA score, serum PCT level and combined prediction probability was 0.712 (95%CI was 0.588-0.836), 0.801 (95%CI was 0.695-0.908), 0.889 (95%CI was 0.798-0.979), 0.943 (95%CI was 0.884-1.000), respectively, indicating that the accuracy of combined parameters to predict survival outcome was higher than that of any single parameter with the sensitivity of 91.7% and the specificity of 83.0%.

CONCLUSIONS

WIC score, SOFA score combined with serum PCT level can improve the accuracy of predicting the 28-day prognosis in patients with sepsis.

Authors+Show Affiliations

Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China. Corresponding author: Huang Xiaobo, Email: 2559936476@qq.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

chi

PubMed ID

31898562

Citation

Zhang, Xiaoqin, et al. "[Prognostic Value of Charlson Weighted Index of Comorbidities Combined With Sequential Organ Failure Assessment Score and Procalcitonin in Patients With Sepsis]." Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, vol. 31, no. 11, 2019, pp. 1335-1339.
Zhang X, Wang Q, Luo X, et al. [Prognostic value of Charlson weighted index of comorbidities combined with sequential organ failure assessment score and procalcitonin in patients with sepsis]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019;31(11):1335-1339.
Zhang, X., Wang, Q., Luo, X., Lei, Y., & Huang, X. (2019). [Prognostic value of Charlson weighted index of comorbidities combined with sequential organ failure assessment score and procalcitonin in patients with sepsis]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 31(11), 1335-1339. https://doi.org/10.3760/cma.j.issn.2095-4352.2019.11.005
Zhang X, et al. [Prognostic Value of Charlson Weighted Index of Comorbidities Combined With Sequential Organ Failure Assessment Score and Procalcitonin in Patients With Sepsis]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019;31(11):1335-1339. PubMed PMID: 31898562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Prognostic value of Charlson weighted index of comorbidities combined with sequential organ failure assessment score and procalcitonin in patients with sepsis]. AU - Zhang,Xiaoqin, AU - Wang,Qian, AU - Luo,Xiaoxiu, AU - Lei,Yu, AU - Huang,Xiaobo, PY - 2020/1/4/entrez PY - 2020/1/4/pubmed PY - 2020/1/11/medline SP - 1335 EP - 1339 JF - Zhonghua wei zhong bing ji jiu yi xue JO - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue VL - 31 IS - 11 N2 - OBJECTIVE: To assess the prognostic value of Charlson weighted index of comorbidities (WIC) combined with sequential organ failure assessment (SOFA) score and procalcitonin (PCT) in sepsis patients in intensive care unit (ICU). METHODS: A prospective cohort study was conducted. 118 patients with sepsis admitted to ICU of Sichuan Provincial People's Hospital from July 2015 to June 2018 were enrolled. The clinical data of the patients including gender, age, pathogenic factors, site of infection, underlying diseases and 28-day prognosis were collected, while the WIC score at ICU admission, the acute physiology and chronic health evaluation II (APACHE II) score and SOFA score within 24 hours after ICU admission, serum PCT level within 1 hour after ICU admission were recorded. The patients were divided into survival group and death group according to 28-day prognosis, and the clinical data of patients with different prognosis were compared. Multivariate Logistic regression model was used to analyze the relationship between WIC score, SOFA score, PCT level and the outcomes of patients. The receiver operating characteristic (ROC) curve was drawn to evaluate the value of WIC score, SOFA score, and PCT level for predicting the prognosis of patients with sepsis. RESULTS: In this study, 118 eligible sepsis patients were enrolled, and 94 patients survived at 28 days, and 24 patients died with a 28-day mortality of 20.3%. Compared with the survival group, the patients in the death group were older and had higher APACHE II score, WIC score, SOFA score, and serum PCT levels. Pathogenic factors analysis showed that the proportion of pulmonary infection in the death group was the highest (62.5%), while in the survival group the main cause was multiple injury (36.2%), followed by pulmonary infection (30.9%). Basic diseases analysis showed that the proportions of tumor, type 2 diabetes, chronic lung disease, cerebrovascular disease, chronic kidney disease, chronic liver disease, and chronic cardiac insufficiency in the death group were significantly higher than those in the survival group. The age [odds ratio (OR) = 1.279, 95% confidence interval (95%CI) was 1.065-1.536], APACHE II score (OR = 1.255, 95%CI was 1.083-1.455), WIC score (OR = 1.429, 95%CI was 1.304-1.568), SOFA score (OR = 1.331, 95%CI was 1.456-1.545), and serum PCT level (OR = 1.497, 95%CI was 1.146-1.547) were related to the 28-day prognosis of patients with sepsis, and were independent predictors of 28-day prognosis in patients with sepsis (all P < 0.01). ROC curve analysis showed that the area under ROC curve (AUC) of WIC score, SOFA score, serum PCT level and combined prediction probability was 0.712 (95%CI was 0.588-0.836), 0.801 (95%CI was 0.695-0.908), 0.889 (95%CI was 0.798-0.979), 0.943 (95%CI was 0.884-1.000), respectively, indicating that the accuracy of combined parameters to predict survival outcome was higher than that of any single parameter with the sensitivity of 91.7% and the specificity of 83.0%. CONCLUSIONS: WIC score, SOFA score combined with serum PCT level can improve the accuracy of predicting the 28-day prognosis in patients with sepsis. SN - 2095-4352 UR - https://www.unboundmedicine.com/medline/citation/31898562/[Prognostic_value_of_Charlson_weighted_index_of_comorbidities_combined_with_sequential_organ_failure_assessment_score_and_procalcitonin_in_patients_with_sepsis]_ L2 - https://medlineplus.gov/sepsis.html DB - PRIME DP - Unbound Medicine ER -