| Objective: To investigate the clinical value of low albuminemia and sepsis in 61 patients with sepsis in Yiyang central hospital.Methods: A retrospective study was conducted on 61 patients with Sepsis admitted to Yiyang central hospital during June 1,2017(solstice,2019)and June 31,2019.The check-in time of all the patients with meeting the criteria for Sepsis to be defined as Sepsis-3,who has complete medical records and course information,is longer than 72 hours.The patients in this study are set strict exclusion criteria.According to the occurrence of hypoalbuminemia,there are normal albumin group and low albumin group.The patients are classified into 4 groups with the different levels of the serum albumin,respectively.Group A is normal albumin levels.(The serum albumin is more than 35 g/L)Group B is mild hypoalbuminemia.(The serum albumin is between 30 and35 g/L)Group C is moderately low serum albumin levels.(The serum albumin is between 25 and30 g/L)Group D is severe hypoalbuminemia group.(The serum albumin is less than 25g/L)Finally,the patients are divided into survival group and death group according to their diagnosis.The intention of this study is the value of statistical analysis serum albumin and other related indicators in the clinical evaluation of patients in each group.Results:1.Baseline data analysis: there was no statistically significant difference(P > 0.05)in gender,age,underlying disease andinfectionsite among the groups of the low albumin group,the normal albumin group and the low albumin group(P > 0.05)2.Among the 61 cases collected,the percentages of the number of patients in the normal proteinemia group and the hypoproteinemia group are 31.1% and 68.9%,respectively,showing statistical significance(P <0.05).3.There are statistically significant differences in APACHE ? score,SOFA score,serum PCT,HGB,PLT,HCT,BUN,fatality rate,length of stay in hospital and length of use of antibiotics among patients in group A,group B,group C and group D(P < 0.05).With the comparision of mortality,APACHE ? score,SOFA score,length of stay,duration of antibiotic use,and PCT and PLT,group C and D compared with group A respectively.The result of the comparison is valid in sense of the statistic(P < 0.05).The comparison of group B and group A is valid according to the length of stay(P < 0.05).The comparison of HCT and HGB in group C and group A is valid.(P < 0.05).The difference of white blood cells and CRP in group A is not valid.(P > 0.05).4.The serum albumin has negative correlation with APACHE ?grade,SOFA,BUN,PCT,with the statistical meaning(P < 0.01);It has positive correlation with HGB,HCT and PLT,with statistical meaning(P<0.01).5.There are statistically meaningful differences in serum albumin,APACHE ? score,PCT and CRP compared the survival group with the death group(P < 0.05).6.The ROC curve used to predict the case fatality rate as follows.The threshold value of serum albumin in predicting death is 24.25g/L.The sensitivity is 76.92%.The specificity is 66.77%.The area under the ROC curve is 0.778(95%CI: 0.648 ~ 0.908).APACHE ? score inpredicting death is 19 points.The threshold of the sensitivity is 69.23%.The specific degree is 75.00%.The area under the curve is 0.735.(95%CI: 0.557 ~ 0.913)The threshold value of SOFA score for predicting death is 8 points.The sensitivity is 69.23%.The specificity is 75.00%.The area under the curve is 0.718(95%CI: 0.546 ~ 0.890).All of results are valid in statistic(P<0.05).Conclusions:1.Patients with sepsis have a high incidence of low albuminemia.Patients with albumin less than 24.25g/L have worse clinical outcome.The detection of serum albumin is of certain reference value for understanding the patient's condition and evaluating the clinical outcome.2.Serum albumin has negative correlation with APACHE ? score,SOFA score and PCT. |
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