The predictive values of complement C3, C4 and cholesterol levels for prognosis of patients with sepsis / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the predictive values of serum complement C3, C4 and cholesterol levels in the prognosis of patients with sepsis. Methods The clinical data of all the patients with sepsis admitted to the Department of Critical Care Medicine of the General Hospital of Xinjiang Military Command from January 2015 to January 2017 were retrospectively analyzed. The levels of serum complement C3, C4, cholesterol, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure score (SOFA), etc. were recorded within 24 hours after admission, the patients were divided into survival group and death group according to the 28-day prognosis, and the differences in various indexes between the two groups were compared respectively;the predictive efficacies of C3, C4 and cholesterol levels in the prognosis of sepsis patients were evaluated by plotting receiver operating characteristic curves (ROC). Results Finally, 120 patients with sepsis were enrolled, including 57 patients in the survival group and 63 patients in the death group. Compared with the survival group, the APACHE Ⅱscore and the SOFA score of the death group were increased significantly (APACHE Ⅱ score: 20.29±5.90 vs. 15.32±5.98, SOFA score: 7.62±3.11 vs. 5.16±2.50, both P < 0.01), however, serum C3, C4 and cholesterol levels were obviously decreased [C3 (g/L): 0.67±0.22 vs. 0.82±0.24, C4 (g/L): 0.17±0.05 vs. 0.20±0.06, cholesterol (mmol/L): 2.77±1.23 vs. 3.46±1.02, all P < 0.01]. ROC curve analyses showed: each of the following items, complement C3, C4, and cholesterol, alone predicting the prognosis of sepsis patients, the area under ROC curve (AUC) and 95% confidence interval (95%CI) were as follows: AUC = 0.680 (95%CI = 0.583-0.777, P = 0.001), AUC =0.657 (95%CI = 0.560-0.754, P = 0.003), and AUC = 0.711 (95%CI = 0.619-0.804, P < 0.001) respectively; when complement C3, C4 and cholesterol combination to predict the prognosis of patients with sepsis, the resulting predictive value was better than the predictive value results obtained by each one of the items or each combination of any two of them (the AUC of C3+C4+cholesterol was 0.725, 95%CI = 0.633-0.817, P < 0.001; the AUC of C3+C4 was 0.697,95%CI = 0.603-0.791, P < 0.001; the AUC of C3 + cholesterol was 0.718, 95%CI = 0.626-0.811, P < 0.001; the AUC of C4+cholesterol was 0.722, 95%CI = 0.629-0.815, P < 0.001). Conclusion Using combination of serum complement C3, C4 and cholesterol levels to predict the prognosis of patients with sepsis may obtain important predicting value, that can provide a reference to clinical doctors.