Early peripheral perfusion index predicts 28-day outcome in patients with septic shock.

IF 2.6 3区 医学 Q1 EMERGENCY MEDICINE
Cheng Chi, Hao Gong, Kai Yang, Peng Peng, Xiaoxia Zhang
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引用次数: 0

Abstract

Background: To investigate the prognostic value of the peripheral perfusion index (PPI) in patients with septic shock.

Methods: This prospective cohort study, conducted at the emergency intensive care unit of Peking University People's Hospital, recruited 200 patients with septic shock between January 2023 and August 2023. These patients were divided into survival (n=84) and death (n=116) groups based on 28-day outcomes. Clinical evaluations included laboratory tests and clinical scores, with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission. Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses. Receiver operator characteristic (ROC) curve was used to assess predictive performance. Mortality rates were compared, and Kaplan-Meier survival plots were created.

Results: Compared to the survival group, patients in the death group were older and had more severe liver damage and coagulation dysfunction, necessitating higher norepinephrine doses and increased fluid replacement. Higher lactate levels and lower PPI levels at 0 h, 6 h, and 12 h were observed in the death group. Multivariate Cox regression identified prolonged prothrombin time (PT), decreased 6-h PPI and 12-h PPI as independent risk factors for death. The area under the curves for 6-h PPI and 12-h PPI were 0.802 (95% CI 0.742-0.863, P<0.001) and 0.945 (95% CI 0.915-0.974, P<0.001), respectively, which were superior to Glasgow Coma Scale (GCS), Sequential Organ Failure Assessment (SOFA) scores (0.864 and 0.928). Cumulative mortality in the low PPI groups at 6 h and 12 h was significantly higher than in the high PPI groups (6-h PPI: 77.52% vs. 22.54%; 12-h PPI: 92.04% vs. 13.79%, P<0.001).

Conclusion: PPI may have value in predicting 28-day mortality in patients with septic shock.

早期外周灌注指数可预测脓毒性休克患者 28 天的预后。
背景:研究脓毒性休克患者外周灌注指数(PPI)的预后价值:研究脓毒性休克患者外周灌注指数(PPI)的预后价值:这项前瞻性队列研究在北京大学人民医院急诊重症监护室进行,在 2023 年 1 月至 2023 年 8 月间招募了 200 名脓毒性休克患者。根据 28 天的结果,这些患者被分为存活组(84 人)和死亡组(116 人)。临床评估包括实验室检查和临床评分,在急诊室入院时以及入院后6小时和12小时评估乳酸和PPI值。采用单变量和多变量 Cox 回归分析法对与死亡率相关的风险因素进行了分析。采用受体运算特征(ROC)曲线评估预测性能。比较了死亡率,并绘制了 Kaplan-Meier 生存图:结果:与存活组相比,死亡组患者年龄更大,肝损伤和凝血功能障碍更严重,需要更高的去甲肾上腺素剂量和更多的液体补充。在死亡组,0 小时、6 小时和 12 小时的乳酸水平较高,PPI 水平较低。多变量 Cox 回归确定凝血酶原时间(PT)延长、6 小时 PPI 和 12 小时 PPI 降低是死亡的独立风险因素。6 小时 PPI 和 12 小时 PPI 的曲线下面积分别为 0.802(95% CI 0.742-0.863,PCI 0.915-0.974,PPC 结论:PPI可能对预测脓毒性休克患者28天的死亡率有一定价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.50
自引率
28.60%
发文量
671
期刊介绍: The journal will cover technical, clinical and bioengineering studies related to multidisciplinary specialties of emergency medicine, such as cardiopulmonary resuscitation, acute injury, out-of-hospital emergency medical service, intensive care, injury and disease prevention, disaster management, healthy policy and ethics, toxicology, and sudden illness, including cardiology, internal medicine, anesthesiology, orthopedics, and trauma care, and more. The journal also features basic science, special reports, case reports, board review questions, and more. Editorials and communications to the editor explore controversial issues and encourage further discussion by physicians dealing with emergency medicine.
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