Prediction and prognostic value of host immune response markers in sepsis
WENG Jie1, SONG Jiaze2, XU Zhe3, TIAN Weihua2, HE Dongyuan2, LIN Jiaying4, YANG Jingwen4, WANG Zhiyi1, 4.
1. Department of General Medicine, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China; 2. The Second Clinical Medical College, Wenzhou Medical University, Wenzhou 325035, China; 3.Department of Emergency Medicine, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China; 4.Department of General Medicine, Taizhou Women and Children’s Hospital Affiliated to Wenzhou Medical University, Taizhou 317700, China
WENG Jie,SONG Jiaze,XU Zhe, et al. Prediction and prognostic value of host immune response markers in sepsis[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(10): 775-781.
Abstract：Objective: To explore the value of host immune response markers in predicting the risk and prognosis of sepsis in patients with infection, and provide reference for the prevention and treatment of sepsis. Methods: From January 2019 to December 2021, adult patients who visited and were hospitalized due to infectious diseases were collected in the Second Affiliated Hospital of Wenzhou Medical University. The demographic data, comorbidities, national early warning score (NEWS), host immune response markers and other data of infected patients were collected. According to whether the infected patients progressed to sepsis, they were divided into infection group and sepsis group. Univariate and multivariate Logistic regression analysis were used to screen host immune response markers that independently predict the progression of infection to sepsis, and the area under the ROC curve (area under curve, AUC), sensitivity, specificity, positive predictive value and negative prediction value to evaluate the predictive performance of markers. Results: A total of 294 infected patients were finally included, among which 138 (46.9%) developed sepsis and 32 died in hospital (10.9%). CD3, CD4, C3, CD19, IL-6, IL-10 and IgE were predictive factors for infection progression to sepsis (OR=0.971, 0.965, 0.973, 1.068, 1.028, 1.569, P<0.05). Among them, IL-10 had the best ability to predict the progression of infection to sepsis, with an AUC of 0.803 (0.753-0.854). After combined with the NEWS, the AUC reached 0.844 (0.797-0.890). IL-6 had the best ability to predict in-hospital death, with an AUC is 0.799 (0.714-0.884). Conclusion: The host immune response markers are dysregulated in the early stage of infection, among which IL-6 and IL-10 have the best ability to predict the progression of infection to sepsis and prognosis,IL-10 combined with NEWS can further improve early sepsis risk identification, which provides reference for sepsis blocking.
