Objective: To explore the early warning value of neutrophil to lymphocyte ratio (NLR) and neutrophil to prealbumin ratio (NPRI) in hospital death and organ dysfunction of septic patients. Methods: The clinical data of 175 patients with sepsis from January 2017 to June 2020 were analyzed retrospectively. The age, sex, basic diseases (hypertension, diabetes and heart disease), sequential organ failure assessment(SOFA),scores of each system in SOFA, number of organ dysfunction, C-reactive protein (CRP), white blood cell number, lymphocyte number, monocyte, neutrophil number, platelet number and albumin on the first day of admission were recorded. Patients were divided into survival group and death group according to whether they died in hospital. According to the scores of each system in SOFA, they were divided into positive group and negative group of organ dysfunction.The value of NLR and NPRI in predicting patients' death and organ dysfunction were analyzed and compared. Results: NLR, NPRI, SOFA and the number of organ injuries in the death group were higher than those in the survival group (P<0.05), while the prealbumin and hospitalization time were less than those in the survival group (P<0.05). Univariate binary Logstic regression analysis showed that NLR (OR=1.046,95%CI 1.020-1.073,P<0.001) and SOFA (OR=1.223,95%CI 1.017-1.471,P=0.032) were independent risk factors for hospital death of sepsis patients, and prealbumin (OR=0.992, 95% CI 0.985-0.998, P=0.017) was an independent protective factor for nosocomial death in patients with sepsis. Receiver operating characteristic curve analysis showed that NLR (AUC=0.706,95% CI 0.524-0.887,P=0.005), NPRI (AUC=0.7586, 95% CI 0.621-0.895, P=0.001), SOFA(AUC=0.715,95%CI 0.615-0.815,P=0.004) and the number of organ injuries (AUC=0.655, 95%CI 0.610-0.818, P=0.043) had certain predictive value for the hospital death of sepsis patients. The difference of NLR between positive and negative groups with abnormal coagulation was statistically significant (P=0.044), and the difference of NPRI between positive and negative groups with renal injury was statistically significant (P=0.021). Conclusion: NLR and SOFA are independent risk factors for nosocomial death in patients with sepsis, and prealbumin is an independent protective factor for nosocomial death in patients with sepsis. NLR, SOFA, NPRI and the number of organ injuries maybe preditive factors for the hospital death of sepsis. |
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