"Developing a new sepsis screening tool based on lymphocyte count, international normalized ratio and procalcitonin (LIP score)"

作者全名："Liu, Bin; Du, Huimin; Zhang, Jing; Jiang, Jie; Zhang, Xin; He, Faming; Niu, Bailin"

作者地址："[Liu, Bin; Zhang, Jing; Jiang, Jie; He, Faming; Niu, Bailin] Chongqing Med Univ, Dept Intens Care Med, Affiliated Hosp 1, Youyi Rd 1, Chongqing 400016, Peoples R China; [Liu, Bin; Niu, Bailin] Chongqing Univ, Cent Hosp, Chongqing Emergency Med Ctr, Dept Intens Care Med,Sch Med, Jiangkang Rd 1, Chongqing 400016, Peoples R China; [Du, Huimin] Chongqing Med Univ, Dept Oncol, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Zhang, Xin] Fudan Univ, Greater Bay Area Inst Precis Med Guangzhou, Shanghai 200433, Peoples R China"

通信作者："Niu, BL (通讯作者)，Chongqing Med Univ, Dept Intens Care Med, Affiliated Hosp 1, Youyi Rd 1, Chongqing 400016, Peoples R China.; Niu, BL (通讯作者)，Chongqing Univ, Cent Hosp, Chongqing Emergency Med Ctr, Dept Intens Care Med,Sch Med, Jiangkang Rd 1, Chongqing 400016, Peoples R China."

来源：SCIENTIFIC REPORTS

ESI学科分类：Multidisciplinary

WOS号：WOS:000886233400001

JCR分区：Q1

影响因子：4.6

年份：2022

卷号：12

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：　

摘要："Exploring an effective sepsis screening tool that can be widely implemented is important for improving the prognosis of sepsis worldwide. This study aimed to develop a new simple screening tool for sepsis (LIP scoring system) that includes the peripheral blood lymphocyte count, international normalized ratio, and procalcitonin level. In a single-center, prospective, observational study, 444 acute sepsis inpatients and 444 nonsepsis inpatients were ultimately included based on the Sepsis-3 and exclusion criteria. The differences in the Lym, INR, PCT level and other clinical biomarkers were compared between the two groups. Univariable and multivariable logistic regression analyses and receiver operating characteristic analysis were used to establish a LIP screening tool for sepsis with a combination of biomarkers. The Kappa and McNemar tests were used to evaluate the differences between the LIP screening results (LIP score >= 3) and Sepsis-3 criteria (SOFA score >= 2). Logistic regression analysis showed that the lymphocyte count, INR, PCT level, platelets, neutrophil/lymphocyte ratio (NLR) and prothrombin time (PT) were independent risk factors for the development of sepsis. The ROC analysis showed that the lymphocyte count, INR, and PCT level had high area under the ROC curve values (AUROC (95% CI): Lym 0.84 (0.810-0.860), INR 0.921 (0.902-0.938), PCT level 0.928 (0.909-0.944)). The LIP tool had satisfactory screening efficacy for sepsis (sensitivity, 92.8%; specificity, 94.1%), and a LIP score equal to or greater than 3 points had good agreement with Sepsis-3 criteria in the diagnosis of sepsis (Kappa = 0862 in the Kappa test and P = 0.512 in the McNemar test). The LIP tool has satisfactory sensitivity and specificity for sepsis screening, and it can be used for rapid screening of patients with sepsis in outpatient and emergency departments or in economically underdeveloped areas with limited resources."

基金机构："Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) [2019MSXM019, 2021MSXM033]; Chongqing Natural Science Foundation Project [cstc2020jcyj-msxmX0124, CSTB2022BSXM-JCX0050]; COVID-19 Emergency Projects of Chongqing Medical University [X1-2611]; Fundamental Research Funds for the Central Universities [2022CDJYGRH-014]; Advanced Medical Talents Project of Middle-Young People in Chongqing"

基金资助正文："This work was supported by the Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) [2019MSXM019] and [2021MSXM033], Chongqing Natural Science Foundation Project [cstc2020jcyj-msxmX0124] and [CSTB2022BSXM-JCX0050], COVID-19 Emergency Projects of Chongqing Medical University [X1-2611], Fundamental Research Funds for the Central Universities [2022CDJYGRH-014] and Advanced Medical Talents Project of Middle-Young People in Chongqing."