Correlation Analysis Of Risk Factors And Predictive Value Of ICU Acquired Weakness In Sepsis Patients

BackgroundSepsis patients are the main population in ICU.There are more than 19 million patients with sepsis globally every year,of which 6 million die.In recent years,with the continuous improvement and update of sepsis related guidelines,more and more patients have survived,however,about 25%-75% of these surviving patients are left with decreased muscle strength of the limbs.This muscle weakness caused by critical illness,in addition to other neuromuscular diseases,is called ICU acquired weakness(ICUAW).Compared with other patients,the ICUAW population has a higher proportion of adverse events such as offline diff ICUlty,death,and multiple organ failure.Even after discharge,these patients are still in a state of poor independent living ability and dysfunction of body function,which has a serious impact on their quality of life,and this dysfunction after discharge also imposes a great burden on the society and the family.This study aims to explore the risk factors of ICUAW in sepsis patients,so as to provide evidence to support the prevention of ICUAW.ObjectiveICU acquired weakness(ICUAW)has limited therapeutic effects and poor prognosis.The study of risk factors for septic ICUAW is helpful for early identification of high-risk patients.MethodsThe case-control experiment included 60 patients with sepsis who were admitted to the ICU from October 20,2020 to February 20,2021.Patients’ age,gender,weight,height,APACHE II,mechanical ventilation,ICUAW length of stay,ICU length of stay,SOFA score,procalcitonin,fasting blood glucose value,lactic acid,C-reactive protein,anti-infection drugs,corticosteroids,sedation analgesia and vascular active drug information is collected for analysis.Univariate Logistic regression was used for preliminary screening of risk factors related to sepsis ICUAW.The preliminary screening results were adjusted for odds ratio(OR)by multivariate binary Logistic regression model.P < 0.05 was considered as an independent risk factor for sepsis ICUAW.Finally,the ROC curve was drawn to compare the predictive value of independent risk factors.ResultAfter univariate Logistic regression and multicollinearity test,the factors that could be included in the binary Logistic regression model were APACHE II score,average SOFA score,average blood lactic acid,mechanical ventilation,,types of antibacterial drugs,sedation and analgesia drug,and vasoactive drugs.Hosmer-Lemchau test P=0.901,the correct percentage of prediction was 85%,and APACHE II the model fit was good.APACHE II(OR=1.17,95%CI[1.004,1.376],P=0.044)and mean SOFA score(OR=1.86,95%CI[1.157,2.981],P=0.01)were independent risk factors.ROC curve analysis showed that the cut-off value of was 19.5,AUC=0.787,sensitivity 75%,specificity 80%,and the cut-off value of average SOFA score was 6.225,AUC=0.881,sensitivity 90%,specificity 80%.Analysis of joint indicators by Bary Logistic regression showed that AUC=0.905,sensitivity 90%,specificity 85%。ConclusionsAverage SOFA score and APACHE II can be used as independent risk factors for the occurrence of ICUAW in patients with sepsis,and their combined predictive value for the occurrence of ICUAW in sepsis is significantly better than that of single indexes.