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Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study

OBJECTIVE: To establish an early warning scoring system for septic shock in patients with digestive tract perforation (DTP) and evaluate its diagnostic efficacy. METHODS: Patients with surgically confirmed or clinically diagnosed DTP admitted to the Department of Intensive Care Medicine of Fujian Pr...

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Autores principales: Chen, Peiling, Gao, Jingqi, Li, Jun, Yu, Rongguo, Wang, Ling, Xue, Fangqin, Zheng, Xiaochun, Gao, Ling, Shang, Xiuling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513145/
https://www.ncbi.nlm.nih.gov/pubmed/36177334
http://dx.doi.org/10.3389/fmed.2022.976963
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author Chen, Peiling
Gao, Jingqi
Li, Jun
Yu, Rongguo
Wang, Ling
Xue, Fangqin
Zheng, Xiaochun
Gao, Ling
Shang, Xiuling
author_facet Chen, Peiling
Gao, Jingqi
Li, Jun
Yu, Rongguo
Wang, Ling
Xue, Fangqin
Zheng, Xiaochun
Gao, Ling
Shang, Xiuling
author_sort Chen, Peiling
collection PubMed
description OBJECTIVE: To establish an early warning scoring system for septic shock in patients with digestive tract perforation (DTP) and evaluate its diagnostic efficacy. METHODS: Patients with surgically confirmed or clinically diagnosed DTP admitted to the Department of Intensive Care Medicine of Fujian Provincial Hospital from June 2012 to October 2021 were retrospectively analyzed. General demographic characteristics, perforation-related information, vital signs, common laboratory indicators, and common ICU scores (Glasgow Coma Scale score, Acute Physiology and Chronic Health Evaluation-II score,Sequential Organ Failure Assessment score) were collected. The patients were divided into shock group and non-shock group according to whether the patients had septic shock during hospitalization. The risk factors of septic shock were screened by basic statistical analysis and multivariate Logistic regression analysis. The receiver operating characteristic curve was drawn to determine the cut-off value of the continuous indicators and discretized with reference to clinic, and the corresponding score was set according to the β regression coefficient of each variable. RESULTS: A total of 176 patients with DTP were included. The average age of the patients was 64.13 ± 14.67 years old, and 74.40% were males. The incidence of septic shock was 30.11% (53/176). Multivariate Logistic regression analysis showed that the highest heart rate≥105 beats/min, Glasgow Coma Scale score≤14 points, lactic acid≥5.75 mmol/L, procalcitonin≥41.47 ug/L, C-reactive protein≥222.5 mg/L were independent risk factors for septic shock in patients with DTP. The total score of clinical diagnostic scoring system of septic shock in patients with DTP was 6 points, including the highest heart rate≥105 beats/min (1 point), lactic acid≥5.75 mmol/L (two points), procalcitonin≥41.47 ug/L (one point), C-reactive protein≥222.5 mg/L (1 point), and Glasgow Coma Scale score≤14 points (1 point). The area under ROC curve (AUC) of this scoring system was 0.789 and the 95% confidence interval was 0.717–0.860 (P < 0.001); when the optimal cut-off value was 2.5, the sensitivity and specificity were 54.70 and 87.80%, respectively. CONCLUSION: This new score system has its certain clinical value and has important guiding significance for clinicians to judge the prognosis of patients with DTP in time.
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spelling pubmed-95131452022-09-28 Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study Chen, Peiling Gao, Jingqi Li, Jun Yu, Rongguo Wang, Ling Xue, Fangqin Zheng, Xiaochun Gao, Ling Shang, Xiuling Front Med (Lausanne) Medicine OBJECTIVE: To establish an early warning scoring system for septic shock in patients with digestive tract perforation (DTP) and evaluate its diagnostic efficacy. METHODS: Patients with surgically confirmed or clinically diagnosed DTP admitted to the Department of Intensive Care Medicine of Fujian Provincial Hospital from June 2012 to October 2021 were retrospectively analyzed. General demographic characteristics, perforation-related information, vital signs, common laboratory indicators, and common ICU scores (Glasgow Coma Scale score, Acute Physiology and Chronic Health Evaluation-II score,Sequential Organ Failure Assessment score) were collected. The patients were divided into shock group and non-shock group according to whether the patients had septic shock during hospitalization. The risk factors of septic shock were screened by basic statistical analysis and multivariate Logistic regression analysis. The receiver operating characteristic curve was drawn to determine the cut-off value of the continuous indicators and discretized with reference to clinic, and the corresponding score was set according to the β regression coefficient of each variable. RESULTS: A total of 176 patients with DTP were included. The average age of the patients was 64.13 ± 14.67 years old, and 74.40% were males. The incidence of septic shock was 30.11% (53/176). Multivariate Logistic regression analysis showed that the highest heart rate≥105 beats/min, Glasgow Coma Scale score≤14 points, lactic acid≥5.75 mmol/L, procalcitonin≥41.47 ug/L, C-reactive protein≥222.5 mg/L were independent risk factors for septic shock in patients with DTP. The total score of clinical diagnostic scoring system of septic shock in patients with DTP was 6 points, including the highest heart rate≥105 beats/min (1 point), lactic acid≥5.75 mmol/L (two points), procalcitonin≥41.47 ug/L (one point), C-reactive protein≥222.5 mg/L (1 point), and Glasgow Coma Scale score≤14 points (1 point). The area under ROC curve (AUC) of this scoring system was 0.789 and the 95% confidence interval was 0.717–0.860 (P < 0.001); when the optimal cut-off value was 2.5, the sensitivity and specificity were 54.70 and 87.80%, respectively. CONCLUSION: This new score system has its certain clinical value and has important guiding significance for clinicians to judge the prognosis of patients with DTP in time. Frontiers Media S.A. 2022-09-13 /pmc/articles/PMC9513145/ /pubmed/36177334 http://dx.doi.org/10.3389/fmed.2022.976963 Text en Copyright © 2022 Chen, Gao, Li, Yu, Wang, Xue, Zheng, Gao and Shang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Chen, Peiling
Gao, Jingqi
Li, Jun
Yu, Rongguo
Wang, Ling
Xue, Fangqin
Zheng, Xiaochun
Gao, Ling
Shang, Xiuling
Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study
title Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study
title_full Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study
title_fullStr Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study
title_full_unstemmed Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study
title_short Construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: A retrospective cohort study
title_sort construction and efficacy evaluation of an early warning scoring system for septic shock in patients with digestive tract perforation: a retrospective cohort study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513145/
https://www.ncbi.nlm.nih.gov/pubmed/36177334
http://dx.doi.org/10.3389/fmed.2022.976963
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