The value of gelsolin for evaluating the prognosis of patients with severe sepsis / 中华急诊医学杂志

ABSTRACT

Objective To evaluate the value of gelsolin for the prognosis of patients with severe sepsis.Methods 50 patients in the emergency intensive care unit of Beijing hospital from January 2015 to July 2015,were determined white blood cell count (WBC),C-reactive protein (CRP),procalcitonin (PCT),gelsolin at admission,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were estimated within 24 hours.According to the 28 days of survival outcome,50 patients were divided into two groupssurvival group and death group.The significant difference of these factors was compared.Binary logistic regression analysis was applied for screening independent risk factors for the prediction of death.The receiver operating characteristic (ROC) curve was applied for the evaluation and comparison about prognosis ability.Results 31 patients were in the survival group,19 patients in the death group.The gelsolin [(21.43±10.54) vs.(13.31±8.54),P=0.007] andAPACHE Ⅱ score [(19.2±6.86) vs.(24.6 ± 8.9),P =0.021] in two groups had significance difference.Binary logistic regression analysis indicated that the gelsolin and APACHE Ⅱ score were independent risk factors of predicting death.The area under of ROC curve (AUC) of the gelsolin was 0.745 (95％ CI0.599-0.851,P =0.004) and the APACHE Ⅱ score was 0.699 (95％ CI0.537-0.862,P =0.019).Both prognosis ability were equivalent.To combine the tow factors,the accuracy of predition was 90％ and has better complementarity.Conclusions the gelsolin could assess the severity of patients with severe sepsis and predict the prognosis more accurately.