Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Apr 19, 2025; 15(4): 102763
Published online Apr 19, 2025. doi: 10.5498/wjp.v15.i4.102763
Relationship between inflammatory factors, lactic acid levels, acute skin failure, bad mood, and sleep quality
Yu-Fei Liu, Wen Cong, Chang-Ming Zhou, Yang Yu, Xin-Jie Zhang
Yu-Fei Liu, Chang-Ming Zhou, Department of Emergency Critical Care Medicine, The Second Hospital of Dalian Medical University, Dalian 116027, Liaoning Province, China
Wen Cong, Department of Psychiatry, Dalian Seventh People’s Hospital (Dalian Mental Health Center), Dalian 116023, Liaoning Province, China
Yang Yu, Xin-Jie Zhang, Department of Intensive Care Medicine, The Second Hospital of Dalian Medical University, Dalian 116027, Liaoning Province, China
Author contributions: Liu YF designed and performed the research and wrote the paper; Cong W and Zhang XJ designed the research and critical revision; Zhou CM and Yu Y acquired, analyzed, and interpreted the data. All authors approved this study.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Second Hospital of Dalian Medical University, No. KY2024-228-01.
Informed consent statement: All study participants or their legal guardians provided written informed consent for the collection of personal and medical data before study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets are available from the corresponding author. Participants provided informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Jie Zhang, Department of Intensive Care Medicine, The Second Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian 116027, Liaoning Province, China. 17709870978@163.com
Received: November 21, 2024
Revised: December 26, 2024
Accepted: February 8, 2025
Published online: April 19, 2025
Processing time: 124 Days and 1.8 Hours
Abstract
BACKGROUND

The central link between septic shock and acute skin failure (ASF) is the inflammatory response, which occurs throughout disease progression and can lead to systemic inflammatory response syndrome. Patients often experience bad moods, sleep disorders, and other health issues. Despite recognizing these factors, no studies have examined the correlation between inflammatory factors, lactic acid levels, ASF, mood disturbances, and sleep quality in critically ill patients. We hypothesize that higher levels of inflammatory factors and lactic acid are associated with more severe ASF and poorer mood and sleep quality, which may inform clinical treatment for septic shock and ASF.

AIM

To explore the relationship between inflammatory factors, lactic acid levels, the severity of ASF, bad mood, and sleep quality.

METHODS

The retrospective study included 150 patients with septic shock from the Second Hospital of Dalian Medical University, categorized into ASF (n = 35) or non-ASF groups (n = 115). We compared the peripheral blood inflammatory factors, including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-6 (IL-6), lactic acid levels, skin mottling score (SMS), modified early warning score (MEWS), self-rating depression scale (SDS), self-rating anxiety scale (SAS), and Pittsburgh sleep quality index (PSQI) scores. Pearson correlation analysis assessed relationships among these variables.

RESULTS

The ASF group had significantly higher levels of CRP (19.60 ± 4.10 vs 15.30 ± 2.96 mg/mL), IL-6 (298.65 ± 48.65 vs 268.66 ± 33.66 pg/L), procalcitonin, lactic acid (8.42 ± 2.32 vs 5.70 ± 1.27 mmol/L), SMS [0 (0, 1) vs 3 (2, 3)], MEWS (9.34 ± 1.92 vs 6.48 ± 1.96), SAS (61.63 ± 12.03 vs 53.71 ± 12.48), SDS (60.17 ± 12.64 vs 52.27 ± 12.64), and PSQI scores (14.23 ± 3.94 vs 8.69 ± 2.46) compared with the non-ASF group (all P < 0.001). Pearson correlation analysis revealed that IL-6, CRP, TNF-α, and lactic acid were positively correlated with SMS, MEWS, SAS, SDS, and PSQI scores (P < 0.05).

CONCLUSION

Peripheral blood levels of IL-6, CRP, TNF-α, and lactic acid correlate positively with SMS, MEWS, SAS, SDS, and PSQI in critically ill patients with ASF.

Keywords: Septic shock; Acute skin failure; Inflammatory factors; Lactic acid level; Degree of acute skin failure; Bad mood

Core Tip: The pathological changes in acute skin failure (ASF) include acute skin hypoperfusion caused by hemodynamic instability in critically ill patients. Systemic inflammatory response syndrome permeates the entire pathological mechanism of septic shock complicated by ASF, and the relevant blood indices can reflect changes in ASF. Bad mood and sleep disturbances are common accompanying symptoms in patients with sepsis, which significantly impact their overall health. Through this project, we found that the levels of peripheral blood-related inflammatory factors and lactic acid were positively correlated with skin mottling score, self-rating anxiety scale, self-rating depression scale, and Pittsburgh sleep quality index scores in critically ill patients with ASF.