{"title":"Evaluation of Sepsis Severity Using Combined High-Density Lipoprotein and Red Cell Distribution Width Indicators.","authors":"Yan Gao, Yao Chen, Li Gao","doi":"10.12968/hmed.2024.0473","DOIUrl":null,"url":null,"abstract":"<p><p><b>Aims/Background</b> Sepsis is a life-threatening condition resulting from dysregulated immune responses to infection, leading to organ dysfunction. High-density lipoprotein (HDL) and red cell distribution width (RDW) have shown significant correlations with sepsis severity, yet the combined prognostic value of HDL and RDW in evaluating sepsis severity and outcomes remains unclear. This study examines the relationship between HDL and RDW levels and sepsis severity, as well as evaluates the combined utility of these markers in predicting disease severity and patient outcomes. <b>Methods</b> This retrospective study included 103 patients diagnosed with sepsis. Clinical data, including HDL and RDW levels, were collected for analysis. Patients were divided into shock and non-shock groups based on the presence of septic shock and into survival and death groups based on 30-day in-hospital mortality. Multivariate logistic regression was used to identify factors influencing sepsis severity and prognosis, while the predictive value of HDL in combination with RDW was evaluated using receiver operating characteristic (ROC) curve analysis. <b>Results</b> Multivariate analysis identified sequential organ failure assessment (SOFA) score (OR = 6.566), interleukin-6 (IL-6) (OR = 2.568), HDL (OR = 0.864), and RDW (OR = 4.052) as independent predictors of sepsis severity (<i>p</i> < 0.05 for all). ROC analysis demonstrated that HDL combined with RDW yielded the highest diagnostic accuracy for sepsis severity, with an area under curve (AUC) of 0.962, sensitivity of 97.56%, and specificity of 91.94%. Additionally, SOFA score (OR = 2.354), interleukin-6 (IL-6) (OR = 1.446), HDL (OR = 0.870), and RDW (OR = 3.502) were independent prognostic indicators (<i>p</i> < 0.05 for all). ROC analysis for prognosis showed that HDL combined with RDW had the highest predictive efficacy for the prognosis of sepsis, with an AUC of 0.922, sensitivity of 79.31%, and specificity of 93.24%. <b>Conclusion</b> The combination of HDL and RDW is a robust indicator for the evaluation of sepsis severity and is a valuable prognostic tool for assessing 30-day mortality risk in sepsis patients.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-12"},"PeriodicalIF":1.0000,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British journal of hospital medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12968/hmed.2024.0473","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Aims/Background Sepsis is a life-threatening condition resulting from dysregulated immune responses to infection, leading to organ dysfunction. High-density lipoprotein (HDL) and red cell distribution width (RDW) have shown significant correlations with sepsis severity, yet the combined prognostic value of HDL and RDW in evaluating sepsis severity and outcomes remains unclear. This study examines the relationship between HDL and RDW levels and sepsis severity, as well as evaluates the combined utility of these markers in predicting disease severity and patient outcomes. Methods This retrospective study included 103 patients diagnosed with sepsis. Clinical data, including HDL and RDW levels, were collected for analysis. Patients were divided into shock and non-shock groups based on the presence of septic shock and into survival and death groups based on 30-day in-hospital mortality. Multivariate logistic regression was used to identify factors influencing sepsis severity and prognosis, while the predictive value of HDL in combination with RDW was evaluated using receiver operating characteristic (ROC) curve analysis. Results Multivariate analysis identified sequential organ failure assessment (SOFA) score (OR = 6.566), interleukin-6 (IL-6) (OR = 2.568), HDL (OR = 0.864), and RDW (OR = 4.052) as independent predictors of sepsis severity (p < 0.05 for all). ROC analysis demonstrated that HDL combined with RDW yielded the highest diagnostic accuracy for sepsis severity, with an area under curve (AUC) of 0.962, sensitivity of 97.56%, and specificity of 91.94%. Additionally, SOFA score (OR = 2.354), interleukin-6 (IL-6) (OR = 1.446), HDL (OR = 0.870), and RDW (OR = 3.502) were independent prognostic indicators (p < 0.05 for all). ROC analysis for prognosis showed that HDL combined with RDW had the highest predictive efficacy for the prognosis of sepsis, with an AUC of 0.922, sensitivity of 79.31%, and specificity of 93.24%. Conclusion The combination of HDL and RDW is a robust indicator for the evaluation of sepsis severity and is a valuable prognostic tool for assessing 30-day mortality risk in sepsis patients.
期刊介绍:
British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training.
The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training.
British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career.
The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.