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중증 패혈증 및 패혈쇼크 환자들의 28일째 사망 예측 인자로서 미성숙 과립구의 평가
Validation of Immature Granulocyte as a Predictor for the 28-Day Mortality in Patients with Severe Sepsis and Septic Shock

대한응급의학회지 2014년 25권 2호 p.167 ~ p.173

고영상(Ko Young-Sang) - 울산대학교 의과대학 서울아산병원 응급의학교실
하상욱(Ha Sang-Ook) - 울산대학교 의과대학 서울아산병원 응급의학교실
정루비(Jeong Ru-Bi) - 울산대학교 의과대학 서울아산병원 응급의학교실
최병호(Choi Byung-Ho) - 울산대학교 의과대학 서울아산병원 응급의학교실

Abstract

Purpose: Recently, several studies for immature granulocyte proportion (IG%) in patients with sepsis have revealed its association with diagnosis and prognosis of patients with sepsis. In this study, we enrolled patients with severe sepsis and septic shock and compared IG% with other biologic markers as a predictor of 28-day mortality.

Methods: This was a retrospective study for patients with severe sepsis and septic shock who were admitted to the emergency department of a tertiary care hospital for fourmonths. The IG% measured using Sysmex XE-2100 and other inflammatory markers, including C-reactive protein, lactate, and procalcitonin were evaluated and compared for 28-day mortality.

Results: A total of 85 patients with septic shock and 45 patients with severe sepsis were enrolled. In the non-survivors group (n=32, 24.6%), APACHE II score (p=0.017), use of continuous renal replacement therapy (CRRT) (p=0.002), and septic shock (p=0.009) were statistically higher compared with thesurvivors group. APACHE 2 score (Odd ratio [OR] 1.099, p=0.008) and IG% (≥0.5%) (OR 3.568, p=0.036) predicted the 28-day mortality independently after adjusting SOFA score, septic shock, disseminated intravascular coagulopathy, use of CRRT, and gender. However, IG (≥0.5%) had low specificity of 33.7% and positive predictive value (PPV) of 30.1% for 28-day mortality.

Conclusion: IG% could be a useful biologic marker for prediction of 28-day mortality in patients with severe sepsis or septic shock. However, the limitation of low specificity and PPV must be considered in clinical use.

키워드

Biologic markers, Granulocytes, Mortality, Sepsis

KMID : 0385920140250020167

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건강보험코드

중증 패혈증 및 패혈쇼크 환자들의 28일째 사망 예측 인자로서 미성숙 과립구의 평가 Validation of Immature Granulocyte as a Predictor for the 28-Day Mortality in Patients with Severe Sepsis and Septic Shock

Abstract

키워드

중증 패혈증 및 패혈쇼크 환자들의 28일째 사망 예측 인자로서 미성숙 과립구의 평가
Validation of Immature Granulocyte as a Predictor for the 28-Day Mortality in Patients with Severe Sepsis and Septic Shock