A scoring system based on novel biomarkers and clinical risk factors to predict invasive candidiasis in immunocompetent critically ill patients.
A scoring system based on novel biomarkers and clinical risk factors to predict invasive candidiasis in immunocompetent critically ill patients.
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DOI：
10.3389/fmicb.2023.1097574
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发表时间：
2023
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
--
作者：
延迟诊断进一步增加了重症监护病房（ICU）患者侵袭性念珠菌病（IC）的死亡率。本研究旨在开发和验证基于新型血清学生物标志物和临床风险因素的评分，用于预测免疫功能正常的ICU患者的IC。我们回顾性地收集了入住ICU时的临床资料和新的血清学标志物。采用多因素Logistic回归分析IC的危险因素，建立IC评分系统。IC患者的C-反应蛋白与白蛋白比值（CAR）和嗜中性粒细胞与淋巴细胞比值（NLR）较高，预后营养指数较低。通过多变量logistic回归分析将NLR、CAR、脓毒症、全肠外营养、1，3-β-D-葡聚糖（BDG）阳性和序贯器官衰竭评估评分确定为IC的独立风险因素，并输入最终评分系统。在开发和验证队列中，该评分的受试者工作特征曲线下面积分别为0.883和0.892，高于念珠菌评分（0.883 vs.0.730，p < 0.001）。我们建立了一个基于NLR，CAR，BDG阳性和临床危险因素的简约评分，可以准确识别ICU患者中的IC，以及时给予治疗，降低死亡率。
Delayed diagnosis further increases the mortality of invasive candidiasis (IC) in intensive care unit (ICU) patients. This study aimed to develop and validate a score based on novel serological biomarkers and clinical risk factors for predicting IC in immunocompetent ICU patients. We retrospectively collected clinical data and novel serological markers on admission to ICU. Multivariate logistic regression was used to identify the risk factors associated with IC, which were adopted to establish a scoring system. Patients with IC had a higher C-reactive protein-to-albumin ratio (CAR) and neutrophil-to-lymphocyte ratio (NLR) and lower prognostic nutritional index than those without IC. The NLR, CAR, sepsis, total parenteral nutrition, 1,3-β-D-glucan (BDG)-positivity, and Sequential Organ Failure Assessment score were identified as independent risk factors for IC by multivariate logistic regression analysis and entered into the final scoring system. The area under receiver operating characteristic curve of the score were 0.883 and 0.892, respectively, in the development and validation cohort, higher than Candida score (0.883 vs.0.730, p < 0.001). We established a parsimonious score based on NLR, CAR, BDG-positivity, and clinical risk factors, which can accurately identify IC in ICU patients to give treatment on time and reduce mortality.
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影响因子：
2.9
作者：
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通讯作者：
Oral, Haluk Barbaros
影响因子：
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Cornely, Oliver A.
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Marchetti, Oscar
影响因子：
11.8
作者：
Donnelly, J. Peter;Chen, Sharon C.;Pappas, Peter G.
通讯作者：
Pappas, Peter G.