The Value Of Oxford Score On The Prognosis Of Patients With Sepsis

Objective: To observe the blood lactate and Oxford acute disease severity score(Oxford acute severity of illness score,OASIS)on the prognosis of patients with sepsis evaluation value,and compare with CRP and PCT,to determine the sepsis patients clinical prognosis and provide treatment recommendations.Methods: 80 cases of emergency sepsis patients hospitalized from October 2016 to October 2017 in EICU in our hospital were retrospectively analyzed.The patients were divided into MODS group(n=45 cases)and non-MODS group(n=35 cases)according to whether they were developed with MODS.According to whether they survived 28 days after admission,they were divided into survival group(n=26 cases)and death group(n=54 cases).The patients were graded by acute severe Oxford system scores after admission;blood lactate value,CRP value,PCT value were daily monitoring and the mean value was calculated.Analyzing and comparing the relationships between MODS group and non-MODS group,survival group and death group respectively according to the indexes.ROC curve was built according to the scores of lactate and procalcitonin,Oxford scores,lactic acid the numerical score + Oxford in the evaluation of prognosis of patients with sepsis.According to the OASIS score,the data of patients were divided into four groups: group I(<15 score,4 cases),group II(16-30 points,22 cases),group III(31-45,48 cases),group IV(46-60,8 cases),and the trend of blood lactate and procalcitonin in different groups were compared.Results: pulmonary infection was the main cause of sepsis in 80 patients with sepsis,accounting for 45%.The number of intraperitoneal infection was the second,accounting for 42.5%.The scores of Oxford score,blood lactate,procalcitonin and Creactive protein in MODS group were significantly higher than those of non-MODS group.The scores of Oxford score,blood lactate,procalcitonin and C-reactive protein of the death group were considerably higher than those of the survival group.The Logistic regression analysis showed that lactic acid,calcitonin and Oxford score could be used as an independent factor to predict the development of sepsis to MODS.The Oxford score and lactate as new variables were tested with analysis of the working curve,found that the area under the ROC curve was 0.814 confidence interval,[95%(0.704-0.923)],0.79[95%CI(0.668-0.912),lactic acid is higher than that of P<0.001],Oxford score 0.662,[95% confidence interval(0.531-0.793),P<0.05] and procalcitonin in 0.787 confidence interval,[95%(0.674-0.901),P<0.01],its sensitivity and specificity were 78% and 85.7%,the description of the lactic acid + Oxford score had higher diagnostic value on the prognosis of patients with sepsis.Conclusion: blood lactic acid,calcitonin and Oxford score can be used to assess the severity and prognosis of patients with sepsis.The value of calcitonin,blood lactic acid and Oxford score in the diagnosis of sepsis was higher than that of C-reactive protein.Blood lactic acid + Oxford score has a good prediction effect on the prognosis of patients with sepsis.There was no significant correlation between the blood lactic acid and calcitonin and the Oxford score.