多种指数对脓毒性休克患者28 d预后的预测价值OA

Objective To evaluate the predictive value of the simplified immune dysregulation index,systemic immune-inflammation index(SII),prognostic nutritional index(PNI),and capillary leakage index(CLI)for short-term prognosis in adult patients with septic shock.Methods A total of 262 adult septic shock patients ad-mitted to the intensive care unit of The First Hospital of Lanzhou University from March 2021 to March 2024 were retrospectively analyzed.Patients were categorized into survival(n=113)and death(n=149)groups based on 28 day outcomes,and clinical data were compared between the groups.Independent risk factors for 28 day mortality were identified using random forest and LASSO Logistic regression,followed by a multi-variate Logistic regression analysis.Receiver operating characteristic curves were used to evaluate the pre-dictive performance of the simplified immune dysregulation index,SII,PNI,and CLI.A nomogram model was subsequently constructed.Results The death group exhibited significantly higher simplified immune dysregulation index,SII,CLI,and sepsis-related organ failure assessment score compared with the survival group(P<0.05),while lymphocyte count and PNI were lower(P<0.05).The combined predictive model demonstrated an area under the receiver operating characteristic curve of 0.96,95%CI:[0.94,0.98],P<0.05.Conclusion Lymphocyte count,simplified immune dysregulation index,SII,PNI,CLI,and sepsis-related organ failure assessment score are independent risk factors for predicting short-term prognosis in septic shock patients,with the nomogram model incorporating these parameters demonstrating strong clinical applicability in predicting 28-day mortality risk of septic shock.