Table 1:
Socio-demographic variables of TBI patients
| Age (years), Median (IQR) | 67 (29–107) | |
|---|---|---|
| Gender (%) | Male | 89 (61%) |
| Female | 57 (39%) | |
| Platelet count | Sepsis group | 55 (37.7%) |
| Septic shock group | 91 (62.3%) | |
| Normal (≥150 G/L) | 100 (68.5%) | |
| Low (100 – 149 G/L) | 13 (8.9%) | |
| Intermediate (50 – 99 G/L) | 31 (21.2%) | |
| Very low (<50 G/L) | 2 (1.4%) | |
| Infection source | Gastrointestinal tract | 64 (43.8%) |
| Respiratory tract | 50 (34.2%) | |
| Urinary tract | 20 (13.7%) | |
| Skin | 9 (6.2%) | |
| Unknown | 3 (2.1%) | |
| Bacteria isolated in blood (n = 37) | K. pneumoniae | 11 (29.7%) |
| P. aeruginosa | 4 (10.8%) | |
| S. aureus | 4 (10.8%) | |
| E.coli | 9 (24.3%) | |
| A. baumannii | 1 (2.7%) | |
| Other | 11 (29.7%) | |
Table 2:
Clinical and laboratory characteristics
| Group Variables | Total (n = 146) | Sepsis (n = 55) | Septic shock (n = 91) | p | Normal platelet (n = 100) | Decreased platelets (n = 46) | p |
|---|---|---|---|---|---|---|---|
| HR (beats/min) | 105.5 ± 21.7 | 102.3 ± 17.9 | 107.4 ± 23.7 | >0.05 | 105.6 ± 21.9 | 105.2 ± 21.6 | |
| RR (beats/min) | 22.1 ± 6.2 | 23.9 ± 5.2 | 21.1 ± 6.5 | 22.7 ± 6.1 | 20.7 ± 6 | ||
| MBP (mmHg) | 78.1 ± 20.1 | 84.5 ± 15.5 | 74.3 ± 21.6 | <0.05 | 79.2 ± 20.6 | 75.7 ± 19.7 | >0.05(a) |
| SOFA score | 7 (6.1 – 7.2) | 4 (4.0 – 5.3) | 8 (7.3 – 8.5) | <0.05 | 5 (4.9 – 6.0) | 9 (8.4 – 9.9) | <0.05(b) |
| WBC (G/L) | 14.3 ± 10 | 16.3 ± 10 | 13.1 ± 9.9 | >0.05 | 15.6 ± 9.5 | 11.4 ± 10.6 | |
| PLT (G/L) | 197.5 ± 100.5 | 228.8 ± 100.3 | 178.5 ± 96.2 | 246.6 ± 82.6 | 90.5 ± 20.8 | ||
| MPV | 9.2 ± 1.8 | 8.8 ± 1.5 | 9.4 ± 1.9 | <0.05 | 8.8 ± 1.6 | 9.9 ± 1.9 | <0.05(a) |
| Procalcitonin (ng/L) | 33.0 (26 – 40.1) | 19.1 (11.2 – 28.4) | 41.6 (31.3 – 50.9) | 22.9 (15.4 – 29.9) | 52.9 (39.1 – 66.6) | ||
| Lactate (mmol/L) | 4.6 (4.0 – 5.2) | 1.9 (1.5 – 2.2) | 6.3 (5.5 – 7.0) | <0.05 | 3.8 (3.0 – 4.2) | 6.6 (5.3 – 7.8) | |
| Albumin (g/dL) | 2.6 (2.5 – 2.7) | 2.7 (2.6 – 2.9) | 2.6 (2.4 – 2.7) | >0.05 | 2.7 (2.6 – 2.9) | 2.5 (2.3 – 2.7) | |
| BE (mmol/L) | −5.1 (−6.6 – −3.2) | 0.1 (−2.8 – 3.7) | −8.1 (−9.5 – −6.7) | −3.7 (−5.5 – −1.1) | −7.7 (−10 – −5.8) | <0.05(b) | |
| L/A | 1.9 (1.6 – 2.1) | 0.7 (0.6 – 0.8) | 2.6 (2.3 – 2.9) | <0.05 | 1.5 (1.2 – 1.7) | 2.8 (2.2 – 3.3) | |
| ICU length (day) | 6.8 ± 6.4 | 7.2 ± 4.2 | 6.6 ± 7.4 | 7.4 ± 7.1 | 5.5 ± 4.2 | ||
| Mortality (n(%)) | 75 (51.4%) | 21 (38.2%) | 54 (59.3%) | <0.05 | 47 (47.0%) | 28 (60.9%) | <0.05(c) |
Fig. 1.
ROC curve of various laboratory parameters in predicting mortality of sepsis patients
Table 3:
Prognostic values of different parameters in the study
| Values Variables | AUROC* | Cut-off threshold | Sensitivity (%) | Specificity (%) | 95% CI |
|---|---|---|---|---|---|
| Lactate (mmol/L) | 0.71 | 6.1 | 44 | 90.1 | 0.63 – 0.79 |
| Albumin (g/dL) | 0.74 | 2.7 | 77.3 | 60.6 | 0.66 – 0.82 |
| L/A | 0.76 | 2.1 | 58.7 | 88.7 | 0.68 – 0.83 |
| PLT (G/L) | 0.65 | 101.5 | 48 | 87.8 | 0.55 – 0.76 |
| WBC (G/L) | 0.48 | # | # | # | 0.36 – 0.59 |
| Procalcitonin (ng/L) | 0.43 | # | # | # | 0.32 – 0.55 |
| BE (mmol/L) | 0.44 | # | # | # | 0.32 – 0.55 |
| SOFA | 0.70 | 6.5 | 72 | 67.3 | 0.59 – 0.80 |
Table 4:
Compare L/A to lactate, albumin, procalcitonin, PLT and SOFA score with Delong test
| Values Variables | L/A (AUROC = 0.76) | |
|---|---|---|
| z-statistic | p | |
| Lactate (AUROC = 0.71) | 3.41 | 0.006 |
| Albumin (AUROC = 0.74) | 2.14 | 0.03 |
| Procalcitonin (AUROC = 0.43) | 2.79 | 0.005 |
| SOFA (AUROC = 0.7) | 1.167 | 0.24 |
| PLT (AUROC = 0.65) | 4.67 | <0.001 |
| BE (AUROC = 0.44) | 2.21 | 0.02 |
| WBC (AUROC = 0.48) | 3.72 | <0.001 |
Table 5:
Prognostic values of L/A ratio in certain some special groups
| Values Variables | AUROC L/A | Cut-off threshold | Sensitivity (%) | Specificity (%) | AUROC lactate | AUROC albumin |
|---|---|---|---|---|---|---|
| Septic shock | 0.79 | 2.1 | 77.8 | 78.4 | 0.73 | 0.77 |
| MODS* | 0.78 | 2.1 | 66.7 | 86.3 | 0.73 | 0.76 |
| ≥ 65 years-old | 0.75 | 2.1 | 60.0 | 86.5 | 0.72 | 0.72 |
Table 6:
Multivariate logistic regression analysis of mortality prediction in sepsis patients
| Values Variables | OR | 95% CI | p | |
|---|---|---|---|---|
| Age (years) | 1.51 | 0.666 – 3.562 | 0.312 | |
| Gender | Female | -- | 0.918 | |
| Male | 0.918 | 0.386 – 2.184 | ||
| Infection stage | Sepsis | -- | 0.038 | |
| Septic shock | 3,558 | 1.071 – 11.817 | ||
| SOFA | 1.266 | 1.036 – 1.549 | 0.021 | |
| Platelet | 1.005 | 1.001 – 1.008 | 0.008 | |
| L/A | 1.134 | 1.068 – 1.205 | <0.001 | |
SOFA score
| Score | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| Respiratory system (PaO2/FiO2 [mmHg (kPa)]) | > 400 (53.3) | ≤ 400 (53.3) | ≤ 300 (40) | < 200 (26.7) and mechanically ventilated including CPAP | < 100 (13.3) and mechanically ventilated including CPAP |
| Coagulation Platelets (×103/μl) | > 150 | ≤ 150 | ≤ 100 | ≤ 50 | ≤ 20 |
| Liver Bilirubin (mg/dl) [μmol/L] | < 1.2 [< 20] | 1.2–1.9 [20–32] | 2.0–5.9 [33–101] | 6.0–11.9 [102–204] | >12.0 [>204] |
| Cardiovascular system Mean arterial pressure OR administration of vasopressors required | MAP ≥70 mmHg | MAP< 70 mmHg | dopamine ≤ 5 μg/kg/min or dobutamine (any dose) | dopamine > 5 μg/kg/min OR epinephrine ≤ 0.1 μg/kg/min OR norepinephrine ≤ 0.1 μg/kg/min | dopamine > 15 μg/kg/min OR epinephrine > 0.1 μg/kg/min OR norepinephrine > 0.1 μg/kg/min |
| Central nervous system Glasgow coma scale | 15 | 13 – 14 | 10 – 12 | 6 – 9 | < 6 |
| Renal function Creatinine (mg/dl) [μmol/L] (or urine output) | < 1.2 [< 110] | 1.2–1.9 [110–170] | 2.0–3.4 [171–299] | 3.5–4.9 [300–440] (or < 500 ml/day) | > 5.0 [> 440] (or < 200 ml/day |