A nomogram based on the value of the dynamic evolution of systemic immune inflammatory index in the evaluation of severe heatstroke.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2024-10-29 DOI:10.1097/SHK.0000000000002485

Chongxiao Xu, Bingling Yin, Yueli Zhao, Haiyang Guo, Xiaogan Hou, Anwei Liu, Xuan He, Wenda Chen, Guodong Lin, Zhiguo Pan

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Abstract

Background: Severe heatstroke patients have a poor prognosis. There are few descriptions of the inflammatory response to heatstroke in clinical studies. Systemic immune-inflammation index(SII) is a new index to reflect the inflammatory state of disease.

Methods: This retrospective observational study included patients who had severe heatstroke between 2010 and 2023. Multivariate logistic regression and nomogram were performed to determine the ability of the SII to predict the prognosis of these patients, and subgroup analysis was performed according to SII levels.

Results: Of the 177 patients included in our study, 28 (15.8%) died. There was no difference in SII values between the first day (p = 0.810) and the second day (p = 0.184) in multivariate analysis. The SII value of the third day (SII 72) was elevated in patients with heatstroke who died compared to that in those who survived (p = 0.035). In multivariable logistic regression, Sequential Organ Failure Assessment (SOFA) score (OR = 1.717, 95%CI: 1.073-2.747, p = 0.024) and SII 72 (OR = 1.001, 95%CI: 1.000-1.002, p = 0.035) were found to be independent predictors of mortality. SII 72 combined with SOFA score distinguished between patients who died and those who survived better than did the separate SOFA score. Patients with SII 72 > 1000 had poor clinical prognosis.

Conclusions: Compared to SII results from the first and second days, third-day results more meaningfully predict poor heatstroke prognosis. SII 72 may be a good indicator, and when combined with SOFA, offers enhanced predictive value.

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基于全身免疫炎症指数动态演变值的重症中暑评估提名图。

背景：重症中暑患者预后较差。临床研究中关于中暑炎症反应的描述很少。全身免疫炎症指数（SII）是一种反映疾病炎症状态的新指数：这项回顾性观察研究纳入了2010年至2023年间的重症中暑患者。方法：这项回顾性观察研究纳入了2010年至2023年期间的重症中暑患者，通过多变量逻辑回归和提名图来确定SII预测这些患者预后的能力，并根据SII水平进行亚组分析：在纳入研究的177名患者中，28人（15.8%）死亡。在多变量分析中，第一天（P = 0.810）和第二天（P = 0.184）的 SII 值没有差异。中暑死亡患者第三天的 SII 值（SII 72）高于存活患者（p = 0.035）。在多变量逻辑回归中，发现序贯器官衰竭评估（SOFA）评分（OR = 1.717，95%CI：1.073-2.747，p = 0.024）和 SII 72（OR = 1.001，95%CI：1.000-1.002，p = 0.035）是预测死亡率的独立因素。SII 72与SOFA评分相结合比单独的SOFA评分更能区分死亡和存活的患者。SII 72 > 1000的患者临床预后较差：结论：与第一天和第二天的 SII 结果相比，第三天的结果更能预测中暑的不良预后。SII 72 可能是一个很好的指标，如果与 SOFA 结合使用，预测价值会更高。

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

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.