GIÁ TRỊ TIÊN LƯỢNG TỬ VONG CỦA SỰ THAY ĐỔI NỒNG ĐỘ PROCALCITONIN, LACTATE HUYẾT THANH, ĐIỂM APACHE II, SOFA Ở BỆNH NHÂN SỐC NHIỄM KHUẨN TẠI BỆNH VIỆN ĐA KHOA TỈNH KIÊN GIANG NĂM 2023-2024

Abstract

Background: Many recent research confirm that the combined use of procalcitonin, serum lactate, APACHE II score, and SOFA score is more reliable than each independent factor in mortality prognosis in patients with septic shock. Objectives: Determining changes in procalcitonin and serum lactate concentrations, SOFA and APACHE II scores in mortality prognosis in patients with septic shock at Kien Giang General Hospital in 2023-2024. Materials and methods: The patients were diagnosed with septic shock according to the Surviving Sepsis Campaign (SSC) 2016. Cross-sectional descriptive study with a sample size of 65 patients. Results: The mortality rate was 27.69%. The results of multivariable binary regression analysis showed that prognostic mortality factors in patients with septic shock included: Each 1% decrease in procalcitonin concentration between 48 hours after shock compared to the time of shock onset, the mortality prognosis decreased by 0.9% (95% confidence interval: 0.1%-1.8%, p=0.028); 1% decrease in serum lactate concentration between 48 hours after shock compared to the time of shock onset, the mortality prognosis decreased by 0.2% (95% confidence interval: 0.02%-0.4%, p =0.046); APACHE II score at the time of shock increased by 1 point, the mortality prognosis increased by 3.3% (95% confidence interval: 0.4%-6.6%; p=0.047). SOFA score was not statistically significant in the mortality prognosis in patients with septic shock (p=0.407). Conclusion: The changes in the concentrations of procalcitonin and serum lactate between 48 hours after shock compared to the time of shock onset and the APACHE II score at the time of shock onset have prognostic value in mortality in patients with septic shock.