Predictive Value of the Systemic Inflammatory Response Index and APACHE II Score for Acute Respiratory Distress Syndrome Caused by Wasp Stings.

IF 2.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Toxicon Pub Date : 2025-01-21 DOI:10.1016/j.toxicon.2025.108252

Zhiwen Zhao, Xiaolin Zhang, Daiqiang Liu, Wentao Tao, Chi Tong, Yongfei Wang, Zhicheng Fang

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引用次数: 0

Abstract

Objective: This study aimed to assess the predictive value of the systemic inflammatory response index (SIRI) and APACHE II score for acute respiratory distress syndrome (ARDS) resulting from wasp stings.

Methods: A retrospective study was conducted, including patients who suffered wasp stings and developed ARDS between January 2018 and November 2024 in the Shiyan area of Hubei province. Based on the 28-day prognosis, patients were categorized into two groups: survivors (n = 21) and non-survivors (n = 25). Clinical data, including demographic characteristics, sting site, clinical symptoms, laboratory findings, and treatment measures, were collected. Univariate and multivariate logistic regression analyses were performed to evaluate the predictive roles of SIRI and APACHE II scores in ARDS prognosis, and their clinical predictive value was assessed using ROC curves.

Results: Significant differences were observed between the survivor and non-survivor groups in APACHE II scores, number of stings, and length of hospitalization (P < 0.05). However, factors such as gender, time of first visit, and site of stings showed no statistically significant differences (P > 0.05). Leukocyte counts, SIRI, and APACHE II scores were significantly lower in the survivor group compared to the non-survivor group (P < 0.05). Multivariate logistic regression analysis revealed that the APACHE II score (OR = 1.42, 95% CI: 1.12-1.79, P = 0.004) and SIRI (OR = 1.27, 95% CI: 1.07-1.49, P = 0.005) were significant independent predictors of 28-day mortality in ARDS patients. ROC curve analysis showed that the AUC for early SIRI was 0.821 (95% CI: 0.693-0.949, P < 0.001), while the AUC for the APACHE II score was 0.809 (95% CI: 0.681-0.936, P < 0.001), indicating that both measures have high clinical predictive value.

Conclusion: This study demonstrated that the APACHE II score and SIRI are valuable tools for predicting the prognosis of ARDS patients caused by wasp stings. Early elevation of these markers is closely associated with an increased risk of mortality and can serve as an effective means of assessing disease severity and mortality risk.

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来源期刊

Toxicon 医学-毒理学

CiteScore

4.80

自引率

10.70%

发文量

358

审稿时长

68 days

期刊介绍： Toxicon has an open access mirror Toxicon: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. An introductory offer Toxicon: X - full waiver of the Open Access fee. Toxicon''s "aims and scope" are to publish: -articles containing the results of original research on problems related to toxins derived from animals, plants and microorganisms -papers on novel findings related to the chemical, pharmacological, toxicological, and immunological properties of natural toxins -molecular biological studies of toxins and other genes from poisonous and venomous organisms that advance understanding of the role or function of toxins -clinical observations on poisoning and envenoming where a new therapeutic principle has been proposed or a decidedly superior clinical result has been obtained. -material on the use of toxins as tools in studying biological processes and material on subjects related to venom and antivenom problems. -articles on the translational application of toxins, for example as drugs and insecticides -epidemiological studies on envenoming or poisoning, so long as they highlight a previously unrecognised medical problem or provide insight into the prevention or medical treatment of envenoming or poisoning. Retrospective surveys of hospital records, especially those lacking species identification, will not be considered for publication. Properly designed prospective community-based surveys are strongly encouraged. -articles describing well-known activities of venoms, such as antibacterial, anticancer, and analgesic activities of arachnid venoms, without any attempt to define the mechanism of action or purify the active component, will not be considered for publication in Toxicon. -review articles on problems related to toxinology. To encourage the exchange of ideas, sections of the journal may be devoted to Short Communications, Letters to the Editor and activities of the affiliated societies.