Background: We aimed to evaluate risk factors and assessment values in patients with sepsis and to explore a method of improving prognosis-prediction efficiency for patients with sepsis.
Methods: Patients with sepsis admitted to the Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University from January 2020 to December 2020 were enrolled. Demographic data of patients and laboratory values at admission were collected. Sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scores were calculated within 24 hours of admission and logistic regression used to analyze risk factors of death within 28 days, as well as the combined predictor of SOFA score and neutrophil:lymphocyte ratio (NLR). Predicted values of various indicators for 28-day mortality in sepsis patients were analyzed using receiver-operating characteristic curves.
Results: A total of 302 patients were included in this study, of whom 64 (21.2%) died. Age, Pct, CRP, Lac, NLR (OR 1.054, 95% CI 1.032– 1.076), SOFA score (OR 1.434, 95% CI 1.293– 1.591), APACHE II score (OR 1.231, 95% CI 1.166– 1.300), and NLR combined with SOFA (SOFA+NLR× 0.149: OR 1.455, 95% CI 1.318– 1.605) were risk factors of 28-day mortality in sepsis patients, and areas under the curve of NLR combined with SOFA score were significantly higher than each of NLR and SOFA scores and similar to APACHE II scores. The sensitivity and specificity of NLR combined with SOFA and APACHE II scores to predict the 28-day prognosis of sepsis patients were better than the other indicators.
Conclusion: NLR combined with SOFA was a risk factor of the death of sepsis patients and its predictive efficacy similar to that of the APACHE II score, which is superior to other predictive indices.
Keywords: sepsis, risk factor, neutrophil to lymphocyte ratio, SOFA, APACHE II