论文部分内容阅读
Objective:The purpose of this study was to verify the predictive value of two novel formulae and compare with that ofprocalcitonin (PCT) for predicting sepsis in trauma patients.Methods:We performed a retrospective study of trauma patients treated at Daping Hospital in Chongqing, China and Affiliated Hospital of Zunyi Medical College between 2010 and 2013.Patients≥16 years old, admitted to hospital after injured within 24 hours and the length of hospital stay ≥48 h were included.Predictive ability of two formulae based on LD50 values of injury severity score (ISS) and new injury severity score (NISS) were verified: ISS/LD50ISS+SIRS score and NISS/LD50NISS+SIRS score, and then were compared with the most common used biomarker procalcitonin (PCT).LD50 values for different age groups and genders were obtained in our former study.The statistical performance of the two formulae and PCT to predict sepsis was evaluated using receiver operating characteristic (ROC) curve analysis.Results:221 trauma patients' data were enrolled in the study, including 44 females and 177 males.The average age of the patients was 44.77±15.01 years.The performance of ISS/LD50Iss+SIRS score and NISS/LD50NISS+SIRS score were equivalent (area under the ROC curve (AUC)=0.816 vs.0.819, P>0.05) and both performed better than PCT (AUC=0.592, P<0.05) in predicting posttraumatic sepsis.For ISS/LD50Iss+SIRS score, the cut-off value was 2.38, with a positive predictive value of 78.08%, a negative predictive value of 81.33%, a sensitivity of 89.06%, a specificity of 65.59%, a positive likelihood ratio of 2.59, a negative likelihood ratio of 0.17, a Youden index of 0.5465, an odds ratio of 15.52, and an accuracy of 79.19%.For NISS/LD50NISS+SIRS score, the cut-off value was 2.4677, with a positive predictive value of 79.70%, a negative predictive value of 75.00%, a sensitivity of 82.81%, a specificity of 70.97%, a positive likelihood ratio of 2.85, a negative likelihood ratio of 0.24, a Youden index of 0.5378, an odds ratio of 11.78, and an accuracy of 77.83%.Conclusions:The two novel formulae ISS/LD50ISS+SIRS score and NISS/LD50NISS+SIRS performed well and both better than PCT in predicting sepsis post trauma.The value of the two formulae can be easily calculated in real-time and can identify the high-risk patients susceptible to sepsis.This method may become an effective way to guide the early assessment and treatment in trauma patients.