老年营养风险指数联合降钙素原清除率和中性粒细胞/淋巴细胞比值对老年脓毒症病人短期预后的预测价值

Predictive value of geriatric nutritional risk index combined with PCTc and NLR for short-term prognosis in elderly patients with sepsis

目的探讨老年营养风险指数(GNRI)、降钙素原清除率(PCTc)、中性粒细胞/淋巴细胞比值(NLR)对老年脓毒症病人短期预后的预测价值。方法选择2018年10月至2021年11月本院收治的97例脓毒症病人作为观察对象,根据28 d病人生存情况将病人分为死亡组(42例)和存活组(55例)。收集病人基本临床资料,比较2组GNRI、PCTc、NLR水平;采用Spearman法分析GNRI、PCTc、NLR与APACHEⅡ评分的相关性,采用ROC曲线分析GNRI、PCTc、NLR对脓毒症病人短期内死亡的预测价值。结果死亡组病人GNRI及PCTc显著低于存活组(P<0.05),NLR、APACHEⅡ评分显著高于存活组病人(P<0.05)。相关性分析显示,GNRI、PCTc与APACHEⅡ评分呈负相关(R=-0.357、-0.401,P<0.001),NLR与APACHEⅡ评分呈正相关(R=0.367,P<0.001);ROC曲线显示GNRI联合PCTc、NLR预测脓毒症病人短期内死亡的AUC为0.850(95%CI:0.763~0.914,P<0.001),敏感度为85.71%,特异度为72.73%。结论老年脓毒症病人GNRI、PCTc降低,NLR升高,三者联合对老年脓毒症病人短期死亡有一定的预测价值。

Objective To investigate the predictive value of geriatric nutritional risk index(GNRI)combined with procalcitonin clearance rate(PCTc)and neutrophil-to-lymphocyte ratio(NLR)foRshort-term prognosis in the elderly patients with sepsis.Methods Ninety-seven patients with sepsis admitted to ouRhospital from OctobeR2018 to NovembeR2021 were enrolled,and the patients were divided into the death group(n=42)and the survival group(n=55)according to the 28-day survival state.The basic clinical data of patients were collected,and the levels of GNRI,PCTc and NLRwere compared between the two groups.Spearman’s correlation coefficient was used to analyze the correlation between GNRI,PCTc,NLRand APACHEⅡscore.The predictive value of GNRI,PCTc and NLRfoRshort-term mortality in the elderly patients with sepsis was analyzed by receiveRoperating characteristic(ROC)curve.Results The levels of GNRI and PCTc were significantly loweRand the levels of NLRand APACHEⅡscore were significantly higheRin the death group than those in the survival group(P<0.05).Correlation analysis showed that GNRI,PCTc were negatively correlated with APACHEⅡscore(R=-0.357,-0.401,P<0.001),and NLRwas positively correlated with APACHEⅡscore(R=0.367,P<0.001).The area undeRthe curve(AUC)of GNRI combined with PCTc and NLRfoRpredicting short-term death in sepsis patients was 0.850(95%CI:0.763-0.914,P<0.001),with a sensitivity of 85.71%and a specificity of 72.73%.Conclusions The levels of GNRI and PCTc are decreased and the level of NLRis increased in the elderly patients with sepsis.The combination of the three indexes has certain predictive value foRshort-term death in the elderly patients with sepsis.