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  1. Article: Value of procalcitonin and presepsin in the diagnosis and severity stratification of sepsis and septic shock.

    Ren, Enfeng / Xiao, Hongli / Wang, Guoxing / Zhao, Yongzhen / Yu, Han / Li, Chunsheng

    World journal of emergency medicine

    2024  Volume 15, Issue 2, Page(s) 135–138

    Language English
    Publishing date 2024-02-22
    Publishing country China
    Document type Journal Article
    ZDB-ID 2753264-1
    ISSN 1920-8642
    ISSN 1920-8642
    DOI 10.5847/wjem.j.1920-8642.2024.028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: CLINICAL CHARACTERISTICS AND PREDICTORS OF MORTALITY DIFFER BETWEEN PULMONARY AND ABDOMINAL SEPSIS.

    Ren, Enfeng / Xiao, Hongli / Li, Jiebin / Yu, Han / Liu, Bo / Wang, Guoxing / Sun, Xuelian / Duan, Meili / Hang, Chenchen / Zhang, Guoqiang / Wu, Caijun / Li, Fengjie / Zhang, Haiyan / Zhang, Yun / Guo, Wei / Qi, Wenjie / Yin, Qin / Zhao, Yunzhou / Xie, Miaorong /
    Li, Chunsheng

    Shock (Augusta, Ga.)

    2023  Volume 60, Issue 1, Page(s) 42–50

    Abstract: Abstract: Background: Pulmonary sepsis and abdominal sepsis have pathophysiologically distinct phenotypes. This study aimed to compare their clinical characteristics and predictors of mortality. Methods: In this multicenter retrospective trial, 1,359 ... ...

    Abstract Abstract: Background: Pulmonary sepsis and abdominal sepsis have pathophysiologically distinct phenotypes. This study aimed to compare their clinical characteristics and predictors of mortality. Methods: In this multicenter retrospective trial, 1,359 adult patients who fulfilled the Sepsis-3 criteria were enrolled and classified into the pulmonary sepsis or abdominal sepsis groups. Plasma presepsin was measured, and the scores of Acute Physiology and Chronic Health Evaluation (APACHE) II, Mortality in Emergency Department Sepsis (MEDS), and Simplified Acute Physiology Score (SAPS) II were calculated at enrollment. Data on 28-day mortality were collected for all patients. Results: Compared with patients with abdominal sepsis (n = 464), patients with pulmonary sepsis (n = 895) had higher 28-day mortality rate, illness severity scores, incidence of shock and acute kidney injury, and hospitalization costs. Lactate level and APACHE II and MEDS scores were independently associated with 28-day mortality in both sepsis types. Independent predictors of 28-day mortality included Pa o2 /F io2 ratio (hazard ratio [HR], 0.998; P < 0.001) and acute kidney injury (HR, 1.312; P = 0.039) in pulmonary sepsis, and SAPS II (HR, 1.037; P = 0.017) in abdominal sepsis. A model that combined APACHE II score, lactate, and MEDS score or SAPS II score had the best area under the receiver operating characteristic curve in predicting mortality in patients with pulmonary sepsis or abdominal sepsis, respectively. Interaction term analysis confirmed the association between 28-day mortality and lactate, APACHE II score, MEDS score, SAPS II score, and shock according to the sepsis subgroups. The mortality of patients with pulmonary sepsis was higher than that of patients with abdominal sepsis among patients without shock (32.9% vs. 8.8%; P < 0.001) but not among patients with shock (63.7 vs. 48.4%; P = 0.118). Conclusions: Patients with pulmonary sepsis had higher 28-day mortality than patients with abdominal sepsis. The study identified sepsis subgroup-specific mortality predictors. Shock had a larger effect on mortality in patients with abdominal sepsis than in those with pulmonary sepsis.
    MeSH term(s) Adult ; Humans ; Retrospective Studies ; Prognosis ; Sepsis ; ROC Curve ; Intraabdominal Infections ; Lactic Acid ; Acute Kidney Injury ; Peptide Fragments ; Lipopolysaccharide Receptors
    Chemical Substances Lactic Acid (33X04XA5AT) ; presepsin protein, human ; Peptide Fragments ; Lipopolysaccharide Receptors
    Language English
    Publishing date 2023-06-03
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 1185432-7
    ISSN 1540-0514 ; 1073-2322
    ISSN (online) 1540-0514
    ISSN 1073-2322
    DOI 10.1097/SHK.0000000000002151
    Database MEDical Literature Analysis and Retrieval System OnLINE

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