Yu Wu , Guosheng Wu , Minyu Li , Yongqing Chang , Miao Yu , Yan Meng , Xiaojian Wan
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We analyzed the correlation between these and LOS.</p></div><div><h3>Results</h3><p>Sixty septic patients were classified into two groups according to whether their intensive care unit (ICU) stay exceeded 14 days. The patients with LOS ≥14 days were older ([72.6±7.5] years <em>vs</em>. [63.3±10.4] years, <em>P</em>=0.015) and had higher Sequential Organ Failure Assessment (SOFA) (median [interquartile range]: 6.5 [5.0–11.0] <em>vs</em>. 4.0 [3.0–6.0], <em>P</em>=0.001) and higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (16.0 [13.0–21.0] <em>vs</em>. 8.5 [7.0–14.0], <em>P</em>=0.001). There was no difference in other demographic characteristics and cytokines, interleukin-6, tumor necrosis factor-α, and interleukin-10 between the two groups. The Th17/Treg ratio of sepsis with LOS <14 days was considerably lower (0.48 [0.38–0.56] <em>vs</em>. 0.69 [0.51–0.98], <em>P</em>=0.001). For patients with LOS ≥14 days, the area under the receiver operating characteristic curve for the Th17/Treg ratio was 0.766. It improved to 0.840 and 0.850 when combined with the SOFA and APACHE II scores, respectively.</p></div><div><h3>Conclusions</h3><p>The Th17/Treg ratio was proportional to septic severity and can be used as a potential predictor of ICU stay in sepsis, presenting a new option for ICU practitioners to better care for patients with sepsis.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 2","pages":"Pages 240-246"},"PeriodicalIF":0.0000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000853/pdfft?md5=321ab9d2b5242e0e171ec49293fa0b44&pid=1-s2.0-S2667100X23000853-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Prediction of Th17/Treg cell balance on length of stay in intensive care units of patients with sepsis\",\"authors\":\"Yu Wu , Guosheng Wu , Minyu Li , Yongqing Chang , Miao Yu , Yan Meng , Xiaojian Wan\",\"doi\":\"10.1016/j.jointm.2023.09.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Prolonged length of stay (LOS) of sepsis can drain a hospital's material and human resources. This study investigated the correlations between T helper type 17 (Th17) and regulatory T (Treg) balance with LOS in sepsis.</p></div><div><h3>Methods</h3><p>A prospective clinical observational study was designed in Changhai Hospital affiliated to Naval Medical University in Shanghai, China, from January to October 2020. The patients diagnosed with sepsis and who met the inclusion and exclusion criteria were recruited and whether the levels of cytokines, procalcitonin, subtypes, and biomarkers of T cells in the peripheral blood were detected. We analyzed the correlation between these and LOS.</p></div><div><h3>Results</h3><p>Sixty septic patients were classified into two groups according to whether their intensive care unit (ICU) stay exceeded 14 days. The patients with LOS ≥14 days were older ([72.6±7.5] years <em>vs</em>. [63.3±10.4] years, <em>P</em>=0.015) and had higher Sequential Organ Failure Assessment (SOFA) (median [interquartile range]: 6.5 [5.0–11.0] <em>vs</em>. 4.0 [3.0–6.0], <em>P</em>=0.001) and higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (16.0 [13.0–21.0] <em>vs</em>. 8.5 [7.0–14.0], <em>P</em>=0.001). There was no difference in other demographic characteristics and cytokines, interleukin-6, tumor necrosis factor-α, and interleukin-10 between the two groups. The Th17/Treg ratio of sepsis with LOS <14 days was considerably lower (0.48 [0.38–0.56] <em>vs</em>. 0.69 [0.51–0.98], <em>P</em>=0.001). For patients with LOS ≥14 days, the area under the receiver operating characteristic curve for the Th17/Treg ratio was 0.766. 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引用次数: 0
摘要
背景脓毒症患者住院时间(LOS)的延长会耗费医院的物力和人力。本研究探讨了脓毒症患者T辅助细胞17型(Th17)和调节性T(Treg)平衡与住院时间的相关性。方法于2020年1月至10月在中国上海海军军医大学附属长海医院设计了一项前瞻性临床观察研究。招募符合纳入和排除标准的脓毒症患者,检测其外周血中细胞因子、降钙素原、亚型和 T 细胞生物标志物的水平。结果根据脓毒症患者在重症监护室(ICU)的住院时间是否超过 14 天,将其分为两组。LOS≥14天的患者年龄较大([72.6±7.5] 岁 vs. [63.3±10.4]岁,P=0.015),序贯器官功能衰竭评估(SOFA)较高(中位数[四分位间范围]:6.5[5.0-11.0]对 4.0 [3.0-6.0],P=0.001),急性生理学和慢性健康评估(APACHE)II 评分更高(16.0 [13.0-21.0] 对 8.5 [7.0-14.0],P=0.001)。两组患者的其他人口统计学特征和细胞因子、白细胞介素-6、肿瘤坏死因子-α和白细胞介素-10均无差异。LOS<14天的脓毒症患者的Th17/Treg比值要低得多(0.48 [0.38-0.56] vs. 0.69 [0.51-0.98],P=0.001)。对于LOS≥14天的患者,Th17/Treg比值的接收者操作特征曲线下面积为0.766。结论 Th17/Treg 比值与脓毒症严重程度成正比,可作为脓毒症患者入住 ICU 的潜在预测指标,为 ICU 医生更好地护理脓毒症患者提供了新的选择。
Prediction of Th17/Treg cell balance on length of stay in intensive care units of patients with sepsis
Background
Prolonged length of stay (LOS) of sepsis can drain a hospital's material and human resources. This study investigated the correlations between T helper type 17 (Th17) and regulatory T (Treg) balance with LOS in sepsis.
Methods
A prospective clinical observational study was designed in Changhai Hospital affiliated to Naval Medical University in Shanghai, China, from January to October 2020. The patients diagnosed with sepsis and who met the inclusion and exclusion criteria were recruited and whether the levels of cytokines, procalcitonin, subtypes, and biomarkers of T cells in the peripheral blood were detected. We analyzed the correlation between these and LOS.
Results
Sixty septic patients were classified into two groups according to whether their intensive care unit (ICU) stay exceeded 14 days. The patients with LOS ≥14 days were older ([72.6±7.5] years vs. [63.3±10.4] years, P=0.015) and had higher Sequential Organ Failure Assessment (SOFA) (median [interquartile range]: 6.5 [5.0–11.0] vs. 4.0 [3.0–6.0], P=0.001) and higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores (16.0 [13.0–21.0] vs. 8.5 [7.0–14.0], P=0.001). There was no difference in other demographic characteristics and cytokines, interleukin-6, tumor necrosis factor-α, and interleukin-10 between the two groups. The Th17/Treg ratio of sepsis with LOS <14 days was considerably lower (0.48 [0.38–0.56] vs. 0.69 [0.51–0.98], P=0.001). For patients with LOS ≥14 days, the area under the receiver operating characteristic curve for the Th17/Treg ratio was 0.766. It improved to 0.840 and 0.850 when combined with the SOFA and APACHE II scores, respectively.
Conclusions
The Th17/Treg ratio was proportional to septic severity and can be used as a potential predictor of ICU stay in sepsis, presenting a new option for ICU practitioners to better care for patients with sepsis.