Analysis of Prognostic Risk Factors in Patients with Septic Shock Based on Circulatory and Cellular Immune Response Indicators

Qiang WANG; Dexing YANG; Weiyu ZHOU; Jiefu TANG; Kai FU; Zhenfang WANG; Shengzhe LIU; Min LI; Ying LUAN; Rong LIU

doi:10.12259/j.issn.2095-610X.S20230716

Volume 44 Issue 7

Jul. 2023

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Qiang WANG, Dexing YANG, Weiyu ZHOU, Jiefu TANG, Kai FU, Zhenfang WANG, Shengzhe LIU, Min LI, Ying LUAN, Rong LIU. Analysis of Prognostic Risk Factors in Patients with Septic Shock Based on Circulatory and Cellular Immune Response Indicators[J]. Journal of Kunming Medical University, 2023, 44(7): 78-87. doi: 10.12259/j.issn.2095-610X.S20230716

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Analysis of Prognostic Risk Factors in Patients with Septic Shock Based on Circulatory and Cellular Immune Response Indicators

doi: 10.12259/j.issn.2095-610X.S20230716

1.
Dept. of ICU，The 1st AffiliatedHospital of Kunming Medical University，Kunming Yunnan 650032
2.
Dept. of Internal Emergency，The 1st People’s Hospital of Yunnan，Kunming Yunnan 650034，China

Received Date: 2023-05-11
Available Online: 2023-07-17
Publish Date: 2023-07-25

Abstract

Abstract

Objective To investigate the prognostic risk factors of patients with septic shock based on circulatory and cellular immune effects, to accurately regulate the noradrenaline dose, alleviate immune function suppression, and improve the success rate of septic shock treatment. Methods This is an observational, retrospective, cohort study. According to the inclusion and exculusion criteria, 160 patients with septic shock treated in ICU of the first affiliated hospital of Kunming medical university from May 2021 to December 2022 were collected, and all of them were given standard cluster treatment. At the same time, according to 28d survival outcome in patients with septic shock was divided into death group （n = 89） and survival group （n = 71）, statistics of two groups of patients admitted to the hospital within 24h baseline data, test indicators, the weighted average dose of noradrenaline, blood gas index, microcirculation index, cellular immunity and early treatment of clinical data in 72h. Meaningful indicators were identified by single-factor analysis, and a multivariate COX proportional risk regression model was applied to screen out independent risk factors affecting the prognosis of patients with septic shock. Results Multivariate COX regression model analysis results showed that: age （HR = 1.05, 95%CI: 1.09～1.12, P = 0.036）, nutritional mode （HR = 0.74, 95%CI: 0.56～0.90, P = 0.037）, the weighted average dose of norepinephrine （HR = 6.21, 95%CI: 4.09～9.43, P < 0.001）, IL-6 （HR = 1.16, 95%CI: 1.09～1.31, P = 0.012）, absolute value of T lymphocytes （HR = 0.47, 95%CI: 0.24～0.91, P = 0.025）, mHLA-DR （HR = 0.46, 95%CI: 0.28～0.75, P = 0.002）.Six factors were independent risk factors affecting the outcome of patients with septic shock to visualize the forest plots presented. Conclusions The age, the weighted average dose of norepinephrine and IL-6 are the dangerous factors affecting the prognosis of patients with septic shock. The hazard ratio is greater than 1. Nutrition, T-lymphocyte absolute value and mHLA-DR are the protection factors affecting the prognosis of patients with septic shock. The hazard ratio is less than 1.
- Septic shock,
- Norepinephrine,
- Cellular immunity,
- Prognostic analysis

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References

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