感染、炎症、修复2026，Vol.27Issue(3)：249-255,7.DOI:10.3969/j.issn.1672-8521.2026.03.007
炎症-免疫-代谢三维轨迹预测脓毒症幸存患者1年生活质量:一项单中心纵向队列分析
Inflammation-immunity-metabolism three-dimensional trajectories for predicting 1-year quality of life in sepsis survivors:A single-center longitudinal cohort analysis
摘要
Abstract
Objective To identify three-dimensional inflammation-immunity-metabolism trajectories in sepsis survivors using group-based multi-trajectory modeling(GBMTM)and to explore the association between different trajectory phenotypes and quality of life one year after hospital discharge.Methods A total of 412 sepsis survivors admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2018 to January 2023 were retrospectively enrolled.Longitudinal data on C-reactive protein(inflammation),absolute lymphocyte count(immunity),and albumin(metabolism)were collected at four time points within 5 days after admission.Quality of life one year after discharge was assessed using the EuroQol Five-Dimensional Five-Level Health Scale(EQ-5D-5L).GBMTM was applied to identify inflammation-immunity-metabolism trajectories.Multivariate logistic regression analysis was performed to explore the association between different trajectory subgroups and the decreased quality of life at one year after discharge.Results Three distinct inflammation-immunity-metabolism trajectory subtypes were identified:Class 1(low inflammation-low immunity-stable metabolism type),Class 2(persistent high inflammation-immunosuppression-poor metabolism type),and Class 3(resolving inflammation-preserved immunity-improved metabolism type).The incidence of decreased quality of life one year after discharge in Class 2[50.56%(180/356)]was significantly higher than that in Class 3[31.82%(7/22)]and Class 1[26.47%(9/34)](χ2=0.009,P<0.05).Multivariate logistic regression analysis revealed that,after adjusting for confounding factors,using Class 1 as the reference,the Class 2 trajectory served as an independent risk factor for decreased quality of life at one year after discharge(OR=3.192,95%CI:1.394-7.902,P=0.009).The area under the receiver operating characteristic curve of the model was 0.758,and both calibration curve and decision curve analysis demonstrated favorable predictive value and clinical utility of the model.Conclusions This study identified three inflammation-immunity-metabolism three dimensional trajectories in sepsis survivors using GBMTM.The Class 2 trajectory was independently associated with decreased quality of life at one year discharge in sepsis survivors.关键词
脓毒症/脓毒症幸存患者/生活质量/EQ-5D-5L/群组多轨迹模型Key words
sepsis/sepsis survivors/quality of life/EuroQol Five-Dimensional Five-Level Health Scale/group-based multi-trajectory modeling引用本文复制引用
骆琳玓,吴倩雯,赵光举,姚奕..炎症-免疫-代谢三维轨迹预测脓毒症幸存患者1年生活质量:一项单中心纵向队列分析[J].感染、炎症、修复,2026,27(3):249-255,7.基金项目
国家自然科学基金(82272202) （82272202）
温州市高水平创新团队项目(2024R3002) （2024R3002）
