Predictive value of combined detection of platelet to lymphocyte ratio, procalcitonin and interleukin-6 in prognosis of patients with sepsis

doi:10.3877/cma.j.issn.1674-6880.2024.02.005

Abstract

Abstract:

Objective

To explore the predictive value of combined detection of platelet to lymphocyte ratio (PLR), procalcitonin (PCT) and interleukin-6 (IL-6) in 28-day prognosis of patients with sepsis.

Methods

The clinical data of 126 patients with sepsis admitted to the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from October 2021 to June 2023 were retrospectively analyzed. According to the clinical outcome of 28 days, they were divided into a survival group (95 patients) and a death group (31 patients). The indexes detected within 24 hours of treatment in the Department of Emergency Medicine were compared between the two groups, including the general information, PLR, PCT, IL-6, lactic acid, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE) II score, platelet count and lymphocyte count. Multivariate logistic regression analysis was used to detect the risk factors affecting the death of sepsis patients. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of PLR, PCT and IL-6 in the prognosis of sepsis patients.

Results

The PLR, PCT, IL-6, lactic acid, SOFA score and APACHEII score of the death group were higher than those of the survival group (all P < 0.05). Multivariate logistic regression analysis showed that the PLR [odds ratio (OR) = 1.018, 95% confidence interval (CI) (1.009, 1.028), P < 0.001], PCT [OR = 1.040, 95%CI (1.018, 1.064), P < 0.001], IL-6 [OR = 1.065, 95%CI (1.004, 1.109), P = 0.045] and APACHEII score [OR = 1.194, 95%CI (1.075, 1.325), P < 0.001] were independent risk factors for adverse outcomes in patients with sepsis. The ROC curve analysis showed that the combined use of PLR, PCT and IL-6 had better predictive value for the 28-day prognosis of sepsis patients than the use of PLR, PCT and IL-6 alone (Z = 2.059, 2.144, 2.001; P = 0.039, 0.032, 0.045).

Conclusion

The levels of PLR, PCT and IL-6 significantly increased in patients who died of sepsis, and they are independent risk factors for predicting the 28-day prognosis of sepsis patients, which are of great value in the prognosis evaluation and deserve further attention.

Key words: Sepsis, Platelet to lymphocyte ratio, Procalcitonin, Interleukin-6, 28-day prognosis

Yajuan Jia, Yuming Meng, Zhiwei Gao, Sumin Gao, Jinsong Zhang, Hong Sun. Predictive value of combined detection of platelet to lymphocyte ratio, procalcitonin and interleukin-6 in prognosis of patients with sepsis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2024, 17(02): 118-123.

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References 26

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组别	例数	年龄（岁， ± s）	性别（例，男/女）	感染部位（例）					PLR	PCT（μg/L）
组别	例数	年龄（岁， ± s）	性别（例，男/女）	肝胆	腹腔	泌尿	肺部	其他	PLR	PCT（μg/L）
存活组	95	66 ± 14	50/45	15	7	45	14	14	100（68，131）	20.6（5.2，47.2）
死亡组	31	66 ± 15	18/13	5	2	4	14	6	165（108，2 262）	65.3（28.1，81.7）
t/Z/χ²值		0.055	0.278	0.002	0.030	11.682	12.517	0.373	4.441	3.945
P值		0.956	0.598	0.964	0.863	<0.001	<0.001	0.541	<0.001	<0.001
组别	例数	IL-6（ng/L）	乳酸（mmol/L）	SOFA评分（分）	APACHEⅡ评分（分， ± s）	血小板计数（× 10⁹/L）	淋巴细胞计数（× 10⁹/L）	CRP（mg/L）	肌酐（μmol/L）
存活组	95	172（75，286）	2.7（1.7，3.5）	8（4，10）	14 ± 6	102（68，158）	0.8（0.4，1.1）	158（102，197）	144（88，228）
死亡组	31	313（170，1 316）	3.8（2.0，5.7）	10（7，13）	21 ± 7	113（56，179）	0.6（0.4，1.2）	140（87，193）	116（89，189）
t/Z/χ²值		3.277	2.241	2.760	3.122	0.207	0.620	0.827	0.651
P值		0.001	0.025	0.006	<0.001	0.836	0.535	0.408	0.515

组别	例数	年龄（岁， ± s）	性别（例，男/女）	感染部位（例）					PLR	PCT（μg/L）
组别	例数	年龄（岁， ± s）	性别（例，男/女）	肝胆	腹腔	泌尿	肺部	其他	PLR	PCT（μg/L）
存活组	95	66 ± 14	50/45	15	7	45	14	14	100（68，131）	20.6（5.2，47.2）
死亡组	31	66 ± 15	18/13	5	2	4	14	6	165（108，2 262）	65.3（28.1，81.7）
t/Z/χ²值		0.055	0.278	0.002	0.030	11.682	12.517	0.373	4.441	3.945
P值		0.956	0.598	0.964	0.863	<0.001	<0.001	0.541	<0.001	<0.001
组别	例数	IL-6（ng/L）	乳酸（mmol/L）	SOFA评分（分）	APACHEⅡ评分（分， ± s）	血小板计数（× 10⁹/L）	淋巴细胞计数（× 10⁹/L）	CRP（mg/L）	肌酐（μmol/L）
存活组	95	172（75，286）	2.7（1.7，3.5）	8（4，10）	14 ± 6	102（68，158）	0.8（0.4，1.1）	158（102，197）	144（88，228）
死亡组	31	313（170，1 316）	3.8（2.0，5.7）	10（7，13）	21 ± 7	113（56，179）	0.6（0.4，1.2）	140（87，193）	116（89，189）
t/Z/χ²值		3.277	2.241	2.760	3.122	0.207	0.620	0.827	0.651
P值		0.001	0.025	0.006	<0.001	0.836	0.535	0.408	0.515

变量	回归系数	标准误	Wald值	P值	OR值	95%CI
PLR	0.018	0.005	15.028	<0.001	1.018	1.009 ~ 1.028
PCT（μg/L）	0.040	0.011	12.395	<0.001	1.040	1.018 ~ 1.064
IL-6（ng/L）	0.063	0.031	5.034	0.045	1.065	1.004 ~ 1.109
乳酸（mmol/L）	0.123	0.068	3.278	0.070	1.131	0.990 ~ 1.239
SOFA评分（分）	0.205	0.118	3.010	0.083	1.227	0.974 ~ 1.547
APACHEⅡ评分（分）	0.177	0.053	10.992	<0.001	1.194	1.075 ~ 1.325

变量	回归系数	标准误	Wald值	P值	OR值	95%CI
PLR	0.018	0.005	15.028	<0.001	1.018	1.009 ~ 1.028
PCT（μg/L）	0.040	0.011	12.395	<0.001	1.040	1.018 ~ 1.064
IL-6（ng/L）	0.063	0.031	5.034	0.045	1.065	1.004 ~ 1.109
乳酸（mmol/L）	0.123	0.068	3.278	0.070	1.131	0.990 ~ 1.239
SOFA评分（分）	0.205	0.118	3.010	0.083	1.227	0.974 ~ 1.547
APACHEⅡ评分（分）	0.177	0.053	10.992	<0.001	1.194	1.075 ~ 1.325

变量	AUC	95%CI	P值	截断值	敏感度	特异度
PLR	0.766	0.668 ~ 0.864	<0.001	135.0	0.677	0.768
PCT（μg/L）	0.737	0.631 ~ 0.842	<0.001	49.5	0.667	0.779
IL-6（ng/L）	0.696	0.598 ~ 0.794	0.001	192.1	0.710	0.653
三者联合	0.828	0.742 ~ 0.913	<0.001	-	0.710	0.821

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