肾动脉阻力指数联合肺动脉高压对脓毒症患者死亡风险的预测价值OACSTPCD

Objective To investigate the applicability of the renal resistive index(RRI)combined with pulmonary hypertension(PH)in predicting the mortality risk of patients with sepsis.Methods The clinical and ultrasonographic data of 115 sepsis patients was retrospectively analyzed who were admitted to the emergency ICU of Beijing Chaoyang Hospital between May 2021 and October 2022.These patients were categorized into the death and survival group based on their 28-day outcomes.The basic information,laboratory tests and bedside ultrasound parameters were compared between the two groups.Logistic regression analysis was used to identify independent factors associated with mortality in sepsis.Receiver operating characteristic(ROC)curves were used to assess the role of age,RRI,and PH in predicting sepsis mortality.Results Among these patients,61 were in the death group and 54 in the survival group.There were statistically significant differences between the two groups in terms of age,oxygenation indexes,lactate levels,B-type natriuretic peptide(BNP),cardiac troponin,RRI,right atrial transverse diameters,right ventricular basal diameters and PH(P＜0.05).Multivariate logistic analysis showed that age,RRI,and PH were independent factors for mortality in sepsis patients(OR=1.087,1.091,3.261,P＜0.05).The areas under the ROC curve for age,renal resistive indexes,and pulmonary hypertension were 0.798,0.729,and 0.711,respectively.The area for combined prediction under the curve for mortality risk in sepsis patients was 0.856,with a sensitivity of 83.6%and a specificity of 81.5%.Conclusion Age≥74 years,RRI≥0.73,and pulmonary hypertension are significant risk factors for mortality in sepsis.RRI combined with PH can be used for early warning to predict the mortality risk in elderly sepsis patients.