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| The predictive value of d-dimer combined with lactic acid in the prognosis of patients with suspected sepsis in emergency department |
| Li Xin-di, Shou Song-tao |
| Department of Emergency, General Hospital, Tianjin Medical University, Tianjin 300052, China |
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Abstract Objective To detect the changes of D-dimer (D-D), Lactic Acid (Lac) and C-reactive protein (CRP), and to investigate the clinical value of D-D and Lac in estimating the prognosis of patients with sepsis. Methods The clinical data of 153 patients with suspected clinical sepsis were retrospectively analyzed. According to the sepsis-3 diagnostic criteria, the patients were divided into septic shock group (n=76), sepsis group (n=75) and simple infection group (n=58). The levels of CRP, DD and Lac were compared between the three groups. Logistic regression analysis was used to screen out the independent risk factors affecting the prognosis of patients with sepsis. The ROC curve was used to evaluate the prognostic value of DD and Lac in patients with sepsis. Results①Comparison of clinical indexes in three groups. The mortality rates of patients in three groups were 0.00%, 37.30% and 81.60%, respectively. The differences among the three groups were statistically significant (P＜0.05). Compared with the simple infection group, the expressions of D-D, Lac and CRP in septic shock group were significantly increased (P＜0.05), while the expression of Lac in sepsis group greatly raised (P＜0.05); the expressions of D-D and Lac in septic shock patients were significantly higher than that of sepsis group (P＜0.05). ②Risk factors for prognosis of the sepsis patients. Logistic regression analysis showed that D-D and Lac were independent risk factors of death of emergency patients with sepsis (P＜0.01). ③Evaluation of prognosis of sepsis patients. The combined predict indicator (AUC=0.892) was significantly greater AUC than single detection of D-D (AUC=0.798), which was of statistical significance (Z=3.287, P＜0.05). There was no statically significant differences of AUC between D-D and Lac (Z=1.609, P＞0.05). Conclusion The changes of CRP, D-D and Lac are closely related to the severity of sepsis. D-D and Lac are independent risk factors for prognosis of sepsis patients. Compared with single detection of D-D, the combined predictor has higher value in estimating the prognosis of sepsis.
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Corresponding Authors:
Shou Song-tao, E-mail: stshou66@sina.com
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