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Zhang J, Zhao Q, Liu S, Yuan N, Hu Z. Clinical predictive value of the CRP-albumin-lymphocyte index for prognosis of critically ill patients with sepsis in intensive care unit: a retrospective single-center observational study. Front Public Health 2024; 12:1395134. [PMID: 38841671 PMCID: PMC11150768 DOI: 10.3389/fpubh.2024.1395134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Sepsis is a complex syndrome characterized by physiological, pathological, and biochemical abnormalities caused by infection. Its development is influenced by factors such as inflammation, nutrition, and immune status. Therefore, we combined C-reactive protein (CRP), albumin, and lymphocyte, which could reflect above status, to be the CRP-albumin-lymphocyte (CALLY) index, and investigated its association with clinical prognosis of critically ill patients with sepsis. Methods This retrospective observational study enrolled critically ill patients with sepsis who had an initial CRP, albumin, and lymphocyte data on the first day of ICU admission. All data were obtained from the Affiliated Hospital of Jiangsu University. The patients were divided into quartiles (Q1-Q4) based on their CALLY index. The outcomes included 30-/60-day mortality and acute kidney injury (AKI) occurrence. The association between the CALLY index and these clinical outcomes in critically ill patients with sepsis was evaluated using Cox proportional hazards and logistic regression analysis. Results A total of 1,123 patients (63.0% male) were included in the study. The 30-day and 60-day mortality rates were found to be 28.1 and 33.4%, respectively, while the incidence of AKI was 45.6%. Kaplan-Meier analysis revealed a significant association between higher CALLY index and lower risk of 30-day and 60-day mortality (log-rank p < 0.001). Multivariate Cox proportional hazards analysis indicated that the CALLY index was independently associated with 30-day mortality [HR (95%CI): 0.965 (0.935-0.997); p = 0.030] and 60-day mortality [HR (95%CI): 0.969 (0.941-0.997); p = 0.032]. Additionally, the multivariate logistic regression model showed that the CALLY index served as an independent risk predictor for AKI occurrence [OR (95%CI): 0.982 (0.962-0.998); p = 0.033]. Conclusion The findings of this study indicated a significant association between the CALLY index and both 30-day and 60-day mortality, as well as the occurrence of AKI, in critically ill patients with sepsis. These findings suggested that the CALLY index may be a valuable tool in identifying sepsis patients who were at high risk for unfavorable outcomes.
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Affiliation(s)
- Jinhui Zhang
- Department of Critical Care Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China
| | | | | | | | - Zhenkui Hu
- Department of Critical Care Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China
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Pedrianes Martín P, Arnás León C, Sánchez Sánchez G, Santana Ojeda B, García Puente I, Comi Díaz C, Calleja Fernández A, de Pablos Velasco PL. [Trends in the characteristics of patients treated with nutritional supplements in the Northern Area of Gran Canaria in the period 2016 -2021]. NUTR HOSP 2024. [PMID: 38450493 DOI: 10.20960/nh.04940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
AIM assess the prescription of oral nutritional supplements (ONS) in the Northern Area of Gran Canaria in the period 2016-2021. MATERIALS AND METHODS based on electronic prescription data, the first ONS prescription during 2016-2021 was analyzed considering age, gender, nutritional requirements (NR), body mass index (BMI), percentage of weight loss (%WL), albumin and number of prescribed ONS per patient. RESULTS 10,595 prescriptions were identified corresponding to 6661 patients with the following characteristics: 46.3 % men, mean age 72.84 ± 15.93 years, BMI 20.60 ± 3.98 kg/m2, %WL 11.89 ± 8.32 %; albumin 3.08 ± 0.63 g/dl. The most frequent etiologies of DRE were: neoplasms 42.6 %; degenerative processes of the CNS 28.9 %; stroke 3.9 %; short intestine 6.9 %, and inflammatory bowel disease (IBD) 5.5 %. The percentages of NR covered by the prescribed ONS were: 100 % in 8.9 % of cases, 50 % in 36.9 %, and 25 % in 54.2 %; 40.4 % of patients received 1 unit of ONS daily, 36.3 % took 2 units of ONS, and 23 % received > 3 units of ONS per day. Greater NR were associated with a greater number of ONS (p < 0.001), but 40.8 % of patients who needed to cover > 50 % of NR received only one unit of ONS. CONCLUSION a significant percentage of patients with DRM do not receive a number of ONS according to their NR.
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Affiliation(s)
- Pablo Pedrianes Martín
- Servicio de Endocrinología y Nutrición. Hospital Universitario de Gran Canaria Doctor Negrín
| | - Claudia Arnás León
- Servicio de Endocrinología y Nutrición. Hospital Universitario de Gran Canaria Doctor Negrín
| | | | - Borja Santana Ojeda
- Servicio de Endocrinología y Nutrición. Hospital Universitario de Gran Canaria Doctor Negrín
| | - Ignacio García Puente
- Servicio de Endocrinología y Nutrición. Hospital Universitario de Gran Canaria Doctor Negrín
| | - Cristina Comi Díaz
- Servicio de Endocrinología y Nutrición. Hospital Universitario de Gran Canaria Doctor Negrín
| | | | - Pedro L de Pablos Velasco
- Servicio de Endocrinología y Nutrición. Hospital Universitario de Gran Canaria Doctor Negrín. Universidad de Las Palmas de Gran Canaria
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Li T, Li X, Zhu Z, Liu X, Dong G, Xu Z, Zhang M, Zhou Y, Yang J, Yang J, Fang P, Qiao X. Clinical value of procalcitonin-to-albumin ratio for identifying sepsis in neonates with pneumonia. Ann Med 2023; 55:920-925. [PMID: 36908271 PMCID: PMC10795557 DOI: 10.1080/07853890.2023.2185673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 02/23/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND It is possible that neonates with pneumonia also have unrecognized sepsis. Identifying sepsis in neonates with pneumonia may cause some trouble for clinicians. This study aimed to evaluate the clinical value of the procalcitonin-to-albumin ratio (PAR) in identifying sepsis in neonates with pneumonia. METHODS We retrospectively included 912 neonates with pneumonia from January 2016 to July 2021. Clinical and laboratory data were collected from electronic medical records. Among neonates with pneumonia, 561 neonates were diagnosed with sepsis, according to the International Pediatric Sepsis Consensus. Neonates were divided into a sepsis group and a pneumonia group. A multivariate logistic regression analysis was used to evaluate whether PAR was a potential independent indicator for identifying sepsis in neonates with pneumonia. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of PAR in sepsis. RESULTS Neonates with sepsis have a higher PAR (p < 0.001). Correlation analysis showed that PAR was positively correlated with the level of C-reactive protein (r = 0.446, p < 0.001). Multiple logistic regression analysis showed that PAR was an independent predictor of the presence of sepsis in neonates with pneumonia. ROC curve analysis revealed that PAR had good power in identifying sepsis in neonates with pneumonia (area under curve (AUC) = 0.72, 95% confidence interval (CI), 0.68-0.75, p < 0.001). CONCLUSION PAR can be used as a new biomarker to identify sepsis in neonates with pneumonia.
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Affiliation(s)
- Tiewei Li
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
- The Center of Henan Children’s Neurodevelopmental Engineering Research, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Xiaojuan Li
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Zhiwei Zhu
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Xinrui Liu
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Geng Dong
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Zhe Xu
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Min Zhang
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Ying Zhou
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Jianwei Yang
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Junmei Yang
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Panpan Fang
- Zhengzhou Key Laboratory of Children’s Infection and Immunity, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, P.R. China
| | - Xiaoliang Qiao
- Center of Laboratory Medicine, Women & Infants Hospital of Zhengzhou, Zhengzhou, P.R. China
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Zhou X, Fu S, Wu Y, Guo Z, Dian W, Sun H, Liao Y. C-reactive protein-to-albumin ratio as a biomarker in patients with sepsis: a novel LASSO-COX based prognostic nomogram. Sci Rep 2023; 13:15309. [PMID: 37714898 PMCID: PMC10504378 DOI: 10.1038/s41598-023-42601-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023] Open
Abstract
To develop a C-reactive protein-to-albumin ratio (CAR)-based nomogram for predicting the risk of in-hospital death in sepsis patients. Sepsis patients were selected from the MIMIC-IV database. Independent predictors were determined by multiple Cox analysis and then integrated to predict survival. The performance of the model was evaluated using the concordance index (C-index), receiver operating characteristic curve (ROC) analysis, and calibration curve. The risk stratifications analysis and subgroup analysis of the model in overall survival (OS) were assessed by Kaplan-Meier (K-M) curves. A total of 6414 sepsis patients were included. C-index of the CAR-based model was 0.917 [standard error (SE): 0.112] for the training set and 0.935 (SE: 0.010) for the validation set. The ROC curve analysis showed that the area under the curve (AUC) of the nomogram was 0.881 in the training set and 0.801 in the validation set. And the calibration curve showed that the nomogram performs well in both the training and validation sets. K-M curves indicated that patients with high CAR had significantly higher in-hospital mortality than those with low CAR. The CAR-based model has considerably high accuracy for predicting the OS of sepsis patients.
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Affiliation(s)
- Xin Zhou
- Department of Emergency/Intensive Care Unit, Wuhan Third Hospital, Tongren Hospital of Wuhan University, No. 216 Guanshan Avenue, Hongshan District, Wuhan, Hubei, China.
| | - Shouzhi Fu
- Department of Emergency/Intensive Care Unit, Wuhan Third Hospital, Tongren Hospital of Wuhan University, No. 216 Guanshan Avenue, Hongshan District, Wuhan, Hubei, China
| | - Yisi Wu
- Cardiac Function Department, Asia Heart Hospital, Wuhan, China
| | - Zhenhui Guo
- Department of 120 Emergency Center, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Wankang Dian
- Department of Emergency/Intensive Care Unit, Wuhan Third Hospital, Tongren Hospital of Wuhan University, No. 216 Guanshan Avenue, Hongshan District, Wuhan, Hubei, China
| | - Huibin Sun
- Department of Emergency/Intensive Care Unit, Wuhan Third Hospital, Tongren Hospital of Wuhan University, No. 216 Guanshan Avenue, Hongshan District, Wuhan, Hubei, China
| | - Youxia Liao
- Department of Emergency/Intensive Care Unit, Wuhan Third Hospital, Tongren Hospital of Wuhan University, No. 216 Guanshan Avenue, Hongshan District, Wuhan, Hubei, China.
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Sun L, Chen Z, Ni Y, He Z. Network pharmacology-based approach to explore the underlying mechanism of sinomenine on sepsis-induced myocardial injury in rats. Front Pharmacol 2023; 14:1138858. [PMID: 37388447 PMCID: PMC10303801 DOI: 10.3389/fphar.2023.1138858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Sepsis, a systemic disease, usually induces myocardial injury (MI), and sepsis-induced MI has become a significant contributor to sepsis-related deaths in the intensive care unit. The objective of this study is to investigate the role of sinomenine (SIN) on sepsis-induced MI and clarify the underlying mechanism based on the techniques of network pharmacology. Methods: Cecum ligation and puncture (CLP) was adopted to induce sepsis in male Sprague-Dawley (SD) rats. Serum indicators, echocardiographic cardiac parameters, and hematoxylin and eosin (H&E) staining were conducted to gauge the severity of cardiac damage. The candidate targets and potential mechanism of SIN against sepsis-induced MI were analyzed via network pharmacology. Enzyme-linked immunosorbent assay was performed for detecting the serum concentration of inflammatory cytokines. Western blot was applied for evaluating the levels of protein expression. Terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling assay was applied to assess cardiomyocyte apoptosis. Results: SIN significantly improved the cardiac functions, and attenuated myocardial structural damage of rats as compared with the CLP group. In total, 178 targets of SIN and 945 sepsis-related genes were identified, and 33 overlapped targets were considered as candidate targets of SIN against sepsis. Enrichment analysis results demonstrated that these putative targets were significantly associated with the Interleukin 17 (IL-17) signal pathway, inflammatory response, cytokines-mediated signal pathway, and Janus Kinase-Signal Transducers and Activators of Transcription (JAK-STAT) pathway. Molecular docking suggested that SIN had favorable binding affinities with Mitogen-Activated Protein Kinase 8 (MAPK8), Janus Kinase 1 (JAK1), Janus Kinase 2 (JAK2), Signal Transducer and Activator of Transcription 3 (STAT3), and nuclear factor kappa-B (NF-κB). SIN significantly reduced the serum concentration of Tumor Necrosis Factor-α (TNF-α), Interleukin 1 Beta (IL-1β), Interleukin 6 (IL-6), Interferon gamma (IFN-γ), and C-X-C Motif Chemokine Ligand 8 (CXCL8), lowered the protein expression of phosphorylated c-Jun N-terminal kinase 1 (JNK1), JAK1, JAK2, STAT3, NF-κB, and decreased the proportion of cleaved-caspase3/caspase3. In addition, SIN also significantly inhibited the apoptosis of cardiomyocytes as compared with the CLP group. Conclusion: Based on network pharmacology analysis and corresponding experiments, it was concluded that SIN could mediate related targets and pathways to protect against sepsis-induced MI.
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Delgado AF. Editorial: Methods in Pediatric Critical Care 2022. Front Pediatr 2023; 11:1158611. [PMID: 36969283 PMCID: PMC10034340 DOI: 10.3389/fped.2023.1158611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/09/2023] [Indexed: 03/29/2023] Open
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Prado CM, Landi F, Chew STH, Atherton PJ, Molinger J, Ruck T, Gonzalez MC. Advances in Muscle Health and Nutrition: A Toolkit for Healthcare Professionals. Clin Nutr 2022; 41:2244-2263. [DOI: 10.1016/j.clnu.2022.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 11/03/2022]
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