Abstract
Objective: To evaluate early prediction value of IPS combined with SchE and D-dimer detection for infection and survival in critically ill patients. Methods: 199 critically ill patients admitted to the emergency intensive care unit (EICU) of our hospital from December 2018 to December 2019 were retrospectively analyzed, including 110 infection patients (infection group) and 89 non-infection patients (non-infection group). According to the survival, the infection group was divided into death group (68 cases) and survival group (42 cases). The IPS, APACHE II, SOFA and SchE, D-dimer expression levels were detected and compared; Univariate and logistic regression analysis were used to evaluate the independent prognostic factors. Results: The IPS and APACHE II of patients in the infected group were higher than those in the non-infected group, the level of SchE was lower than that in the non-infected group, and the level of D-dimer was higher than that in the non-infected group (P 0.001). IPS, SOFA, APACHE II, SchE, D-dimer, invasive mechanical ventilation, septic shock, and ICU length of stay had significant influence on the prognosis of critically ill patients (P 0.001). Logistic regression analysis showed that IPS (OR = 2.821, 95% CI 1.501 - 5.227), SOFA (OR = 5.078, 95% CI 3.327 - 7.690), APACHE II (OR = 14.308, 95% CI 8.901 - 21.893), SchE (OR = 0.223, 95% CI 0.165 - 0.291), D-dimer (OR = 2.10, 95% CI 1.55 - 2.85), septic shock (OR = 9.948, 95% CI 7.012 - 17.012) were independent factors affecting the prognosis of critically ill patients with infection (P 0.001). Conclusion: IPS and D-dimer expression level in infected patients were increased and SchE decreased significantly compared with those in non-infected patients, and they significantly correlated with disease severity of infected patients and could be early prediction for prognosis.
Highlights
Ill infection has no strong clinical characteristics at the initial stage of the disease, but the disease develops rapidly and has a very high fatality rate [1]
Logistic regression analysis showed that Infection probability Score (IPS) (OR = 2.821, 95% CI 1.501 - 5.227), Sequential Organ Failure Assessment (SOFA) (OR = 5.078, 95% CI 3.327 - 7.690), APACHE II (OR = 14.308, 95% CI 8.901 - 21.893), Serum cholinesterase (SchE) (OR = 0.223, 95% CI 0.165 - 0.291), D-dimer (OR = 2.10, 95% CI 1.55 2.85), septic shock (OR = 9.948, 95% CI 7.012 - 17.012) were independent factors affecting the prognosis of critically ill patients with infection (P < 0.001)
Score of IPS and APACHE II in the infected group was higher than that in the non-infected group (P < 0.001), but there was no significant difference in the SOFA score. (P > 0.05).The SchE expression level of the infected group was lower than that of the non-infected group, and the expression level of D-dimer (OR = 2.10, 95% CI 1.55 - 2.85) was higher than that of the non-infected group (P < 0.001) (Table 2)
Summary
Ill infection has no strong clinical characteristics at the initial stage of the disease, but the disease develops rapidly and has a very high fatality rate [1]. Sequential Organ Failure Assessment (SOFA) is a common organ failure score [3], Acute Physiology and Chronic Health Evaluation II (APACHE II) for critical disease diagnosis are significance; Infection probability Score (IPS) [4] is a quantitative measure of the likelihood of infection, the relationship between the level of infection and the other two scoring systems is not clear [5]. Serum cholinesterase (SchE), as a factor involved in acetylcholine degradation has been confirmed to be closely correlated with its expression level in infectious diseases [6]. IPS, SchE and D-dimer expression levels of critically ill patients were observed to explore the correlation between the indicators and severe infections, and to provide reference significance for the prediction of diagnosis and prognosis incritically ill infection
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