结核病危重症患者乳酸值、血小板计数和序贯器官衰竭评估评分对预后的联合预测效能OA

Objective To explore the combined predictive efficacy of lactate(LAC)level,platelet count,and sequential organ failure assessment(SOFA)score for the prognosis of critically ill tuberculosis patients.Methods A total of 323 critically ill tuberculosis patients were enrolled.Patients were divided into survival group(n=158)and death group(n=165)according to clinical outcomes.Multivariate logistic regression analysis was performed to identify prognostic factors,and ROC curves were constructed to evaluate the predictive value of LAC level,platelet count,and SOFA score alone and in combination for patients'prognosis.Results Comparison of clinical parameters between the survival group and the death group showed statistically significant differences in LAC,red blood cell count,hemoglobin,platelet count,fibrinogen(FIB),and SOFA score(P<0.05).Multivariate logistic regression analysis indicated that elevated LAC level,decreased platelet count,and increased SOFA score were risk factors for poor survival outcomes of critically ill tuberculosis patients(P<0.05).ROC curve analysis showed that the combination of LAC,platelet count,and SOFA score achieved an AUC of 0.766 for predicting mortality in critically ill TB patients,with the optimal cut-off value of 0.296,sensitivity of 0.847,and specificity of 0.509(P=0.001),suggesting that the combination of multiple indicators can improve the prediction accuracy.Conclusions The predictive model combining LAC levels,platelet count,and SOFA score demonstrates significantly superior prognostic performance for critically ill patients with tuberculosis compared with models using LAC,platelet count,or SOFA score alone.This combined model supports a more accurate assessment of disease severity in critically ill tuberculosis patients and facilitates more informed clinical decision-making.