Background We aimed to evaluate risk factors and assessment values in patients with sepsis and to explore a method of improving prognosis-prediction efficiency for patients with sepsis. Methods Patients with sepsis admitted to the Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University from January 2020 to December 2020 were enrolled. Demographic data of patients and laboratory values at admission were collected. Sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scores were calculated within 24 hours of admission and logistic regression used to analyze risk factors of death within 28 days, as well as the combined predictor of SOFA score and neutrophil:lymphocyte ratio (NLR). Predicted values of various indicators for 28-day mortality in sepsis patients were analyzed using receiver-operating characteristic curves. Results A total of 302 patients were included in this study, of whom 64 (21.2%) died. Age, Pct, CRP, Lac, NLR (OR 1.054, 95% CI 1.032–1.076), SOFA score (OR 1.434, 95% CI 1.293–1.591), APACHE II score (OR 1.231, 95% CI 1.166–1.300), and NLR combined with SOFA (SOFA+NLR×0.149: OR 1.455, 95% CI 1.318–1.605) were risk factors of 28-day mortality in sepsis patients, and areas under the curve of NLR combined with SOFA score were significantly higher than each of NLR and SOFA scores and similar to APACHE II scores. The sensitivity and specificity of NLR combined with SOFA and APACHE II scores to predict the 28-day prognosis of sepsis patients were better than the other indicators. Conclusion NLR combined with SOFA was a risk factor of the death of sepsis patients and its predictive efficacy similar to that of the APACHE II score, which is superior to other predictive indices.

This study investigates the prognostic value of immune cell subsets in assessing the risk of death in patients with sepsis. This retrospective study collected 169 patients from March 2020 to February 2021 at our hospital. Baseline data were collected from patients. The absolute values (Abs) and percentages (%) of immune cell subsets for lymphocytes, T cells, CD4+ cells, CD8+, B cells, NK cells, and NKT cells were measured using flow Cytometry. Among the included patients, 43 patients were in the nonsurvivor group and 126 patients were in the survivor group. The age of patients in the nonsurvivor survivor was higher than that of survivor group patients ( P = .020). SOFA, APACHE II, C-reactive protein, and procalcitonin were higher in the nonsurvivor group than in the survivor group (all P values < .05). Multivariate regression analysis showed that lymphocytes (%) and SOFA were independent risk factors affecting patients’ prognosis. Lymphocytes (%) have the highest area under the receiver operating characteristic (ROC) curve (0.812). The model area under the ROC curve for immune cell subsets was 0.800, with a sensitivity of 72.09%, and specificity of 79.27% ( z = 7.796, P <  .001). Analysis of patient prognosis by immune cell subsets diagnostic showed statistically significant differences in the grouping of cut-off values for all 5 indicators (all P < .05). The lymphocytes (%) and SOFA score are independent risk factors affecting the prognosis of patients. A moderate predictive power for mortality in sepsis patients by immune cell subsets model.

Background: In order to evaluate the risk factors and its assessment values in patients with sepsis, and to explore a method to improve the prognosis prediction efficiency of patients with sepsis.Methods: Patients with sepsis admitted to Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University from January 2020 to December 2020 were enrolled, and they were divided into survival group and death group according to the prognosis at 28 days. Demographic data of patients and laboratory values at admission were collected. In terms of the first time data within 24h of patients admitted to hospital, the sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were calculated, and compared the difference between the two groups, the logistic regression was used to analysis the risk factors for death within 28 days, as well as the calculated combined predictor of SOFA and neutrophil to lymphocyte ratio (NLR). Predicted values of various indicators for 28 days’ mortality in sepsis patients were analyzed by receiver operating characteristic (ROC) curve.Results: 302 patients in total were included in this study, including 238 patients in survival group and 64 patients in death group. The age (78.36±9.8 years old vs. 71.6±14.1 years old), procalcitonin (PCT) (1.00 ng/ml vs. 0.05 ng/ml), C-reactive protein (CRP) (93 mg/l vs 14 mg/l), lactic acid (Lac) (1.20 mmol/l vs. 2.20 mmol/l), NLR (11.7 vs. 6.20), SOFA score (8 vs. 4) and APACHE Ⅱ score(20.5 vs. 11.0) of death group were significantly higher than those of survival group (all P<0.001). Age (OR=1.046, 95%CI 1.020-1.074, P=0.001), PCT (OR=1.115, 95%CI 1.055-1.177, P<0.001), CRP (OR=1.016, 95%CI 1.011-1.021, P<0.001), Lac (OR=1.887, 95%CI 1.518-2.346, P<0.001), NLR (OR=1.038, 95%CI 1.016-1.060, P=0.001), APACHE Ⅱ score (OR=1.231, 95%CI 1.166-1.300, P<0.001), SOFA score (OR=1.499, 95%CI1.344-1.671, P<0.001), NLR combined SOFA (SOFA+NLR×0.085) (OR=1.492, 95%CI1.341-1.660, P<0.001) were risk factors of 28 days’ mortality in sepsis patients, and the area under the curve (AUC) of APACHE Ⅱ, NLR combined SOFA were 0.853 and 0.855, higher than Lac (0.767, P<0.05), CRP (0.746, P<0.05) and PCT (0.761, P<0.05), the AUC of APACHE Ⅱ was similar with NLR combine SOFA (P>0.05). The sensitivity and specificity of APACHE Ⅱ and NLR combined SOFA to predict the 28 days’ prognosis of sepsis patients were better than the other indicators. Conclusion: NLR combined SOFA was a risk factor for the death of sepsis patients, and its predictive efficacy was similar with that of APACHE Ⅱ score, which is superior to other predictive indexes.