Sepsis and Septic Shock: Are Initial mSOFAScore, Point-of-Care Lactate, Neutrophil-Lymphocyte Ratio and Platelet Count Good Predictors for Mortality?
Journal Title: International Journal Of Medical Science And Clinical Research Studies - Year 2023, Vol 3, Issue 01
Abstract
Background:Sepsis is a common life threatening medical problem and first leading cause of death in Myanmar. This study was aimed to determine the predictive values of initialmSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet countfor mortality in patients with sepsis and septic shock.Method:A hospital based prospective observational study done in No.(1) Defence Services General Hospital, Yangon, from January 2021 to October 2022. All patients above 18 years old admitted with sepsis and qSOFA≥2 were enrolled and sample size was 121 patients. The predictors were mSOFA score, point-of-care lactate, neutrophil-lymphocyte ratio and platelet count,which were assessed within 24 hour of admission and the mortality was observed for 28 days. Logistic regression was used to find out the predictive value andthe predictors were compared by receiver operating characteristic curveanalysis.Results:The initial mSOFA score, point-of-care lactate and neutrophil-lymphocyte ratio of non survivors weresignificantly higherthan survivors (mSOFA score 9vs 4),(blood lactate 3.3mmol/L vs 2mmol/L),(neutrophil-lymphocyte ratio 13.4vs 8.3). Platelet count was significantly lower in non-survivors than survivors (175 x 10^9/L vs 290 x 10^9/L). The mortality was 33.1%. The mSOFA score and lactate were strongly correlated (rho= 0.650, p< 0.001). The adjusted odds ratio of mSOFA score was 1.350(1.135–1.606)with adjusted R20.478 and accuracy80.2%. The adjusted odds ratioof lactate was 1.819(1.168–2.834);NLR, 1.108(1.023–1.200); platelet0.992 (0.987 –0.998)with adjusted R20.616 and accuracy 86.8%. Each predictor hadmoderate prognostic value (AUC >0.7) and the combinations of mSOFA score and/or lactate with NLR and platelet count, good prognostic value (AUC > 0.8).Conclusion:The mSOFA score, lactate, NLR and platelet count had predictive value for mortality assessment in patients with sepsis or septic shock.Lactate level was strongly correlated with disease clinical severity of the sepsis, mSOFA score. The combination of mSOFA score and/or lactate with NLR and platelet count had better predictive value.
Authors and Affiliations
Zar Ni Htet Aung, Nyan Lin Maung, Soe Win Hlaing, Soe Min Aung,Zay Phyo Aung,Sitt Min,Kyaw Khaing,Sai Aik Hla& Khin Phyu Pyar
Keywords
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- EP ID EP739729
- DOI 10.47191/ijmscrs/v3-i1-12
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