Observational Study
Copyright ©The Author(s) 2023.
World J Clin Cases. Jun 6, 2023; 11(16): 3765-3779
Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3765
Table 1 Comparison of Group 1 and Group 2
Variable
Group 1
Group 2
P value
mean ± SD
Min-Max
Median (Q1-Q3)
mean ± SD
Min-Max
Median (Q1-Q3)
Age62.34 ± 14.3220-9264 (56-73)61.03 ± 15.1025-8266.5 (52-72)0.843
APACHE II20.82 ± 5.479-3220 (17-25)23.78 ± 5.418-3324 (21-28)0.002a
SOFA score9.26 ± 4.222-188 (6-13)8.88 ± 3.444-168 (6-11.75)0.751
Hemoglobin11.24 ± 6.307.1-16.7010.2 (9.10-12.20)10.26 ± 1.937.1-1610.25 (8.75-11.7)0.299
TLC12.37 ± 7.920.1-46.5011.9 (6.70-16.70)12.56 ± 9.341.4-42.809.65 (6.5-16.65)0.668
Platelet count2.17 ± 1.010.1-5.261.98 (1.63-2.78)2.08 ± 0.720.25-3.182.02 (1.61-2.75)0.904
Serum bilirubin1.84 ± 2.780.16-18.570.8 (0.55-1.6)1.68 ± 2.240.28-10.930.81 (0.41-1.84)0.507
Serum albumin3.0 ± 0.601.5-4.42.9 (2.60-3.50)2.9 ± 0.601.7-42.9 (2.30.-3.40)0.584
INR1.35 ± 0.360.95-3.831.28 (1.12-1.49)1.31 ± 0.301.01-2.521.26 (1.08-1.44)0.323
Creatinine1.59 ± 1.310.2-10.501.3 (0.70-1.90)1.34 ± 0.910.20-4.201.15 (0.6-1.85)0.265
Urea51.68 ± 34.757.8-22941.7 (29.70-64.60)54.12 ± 35.303.3-15744 (33.1-69.88)0.565
Heart rate104.15 ± 15.4464-156107 (94-114)106.73 ± 15.6570-137112 (98-118.75)0.216
SBP101.6 ± 22.1650-166102 (90-117)99.5 ± 21.5360-133102 (81-117.75)0.629
DBP56.92 ± 15.2624-9758 (45-66)58.58 ± 15.6536-9059 (44-68.75)0.685
MAP71.62 ± 16.0831-10670 (64-82)72.5 ± 16.4744-10370.5 (61.75-87)0.808
Lactate at 0 h4.87 ± 1.69 2.1-9.704.6 (3.50-5.90)4.76 ± 1.752.3-9.84.15 (3.5-5.65)0.594
Lactate at 3 h4.22 ± 2.01.3-12.003.6 (2.80-5.20)3.82 ± 2.061.9-12.403.4 (2.45-4.10)0.16
Lactate at 6 h 3.91 ± 3.010.6-14.102.8 (2.0-4.60)3.88 ± 3.480.9-16.702.7 (2.0-4.20)0.7
CRT at 0 h5.14 ± 2.162-125 (3-7)2.25 ± 0.671-32 (2-3)< 0.001a
CRT at 3 h4.72 ± 2.681.0-13.004 (3-7)3.55 ± 22-93 (2-4)0.011a
CRT at 6 h4.50 ± 3.301.0-13.003 (2-7)3.88 ± 3.221-133 (2-4)0.255
ScvO2 at 0 h64.5 ± 9.1042.8-74.2070.4 (56.40-71.80)71.8 ± 1.3068.1-74.071.8 (70.9-72.70)< 0.001a
ScvO2 at 3 h60.1 ± 7.036.8-73.7060.8 (56.70-64.70)63.8 ± 4.7052.8-73.5063.6 (61.7-67.3)0.002a
ScvO2 at 6 h58.6 ± 9.036.7-89.2060.2 (52.30-64.90)62.4 ± 6.8042.3-71.063.7 (58.7-68.3)0.010a
P(cv-a)CO2 at 0 h6.63 ± 1.782.9-9.807.2 (5-7.9)4.24 ± 0.842.8-5.804.2 (3.6-4.86)< 0.001a
P(cv-a)CO2 at 3 h5.81 ± 2.032.6-12.305.5 (4.10-7)5.05 ± 1.512.7-104.4 (4-5.98)0.035a
P(cv-a)CO2 at 6 h5.70 ± 2.302.6-12.405.1 (4-60.5)5.88 ± 6.882.6-474.3 (3.6-6.375)0.059
Lactate clearance at 3 h10.2 ± 38.5(-183.3-57.7)22.7 (-7.30-36.0)18.3 ± 29.8(-103.3-58.2)26.7 (5.4-36.4)0.332
Lactate clearance at 6 h15.3 ± 76.0(-433.3-100.0)39.6 (5.1-57.1)20.3 ± 54.8(-173.8-76.9)39.1 (2.4-57.9)0.973
Table 2 Comparison of baseline patient characteristics between Group 1 and Group 2
CharacteristicsGroup 1
Group 2
Total
P value
Frequency
%
Frequency
%
Frequency
%
Sex
Female4345%2050%6395%0.614
Male5255%2050%72105%
Comorbidities
DM3032%1230%4231%0.856
HTN3941%1538%5440%0.700
COPD66%513%118%0.393
CLD77%410%118%0.868
CKD1213%820%2015%0.271
Malignancy77%410%118%0.868
CAD88%615%1410%0.403
Others IMM55%25%75%1.000
Source of infection
Intra-abdominal infection2728%1230%3929%0.853
Bacteremia1112%38%1410%0.689
Pneumonia3032%1128%4130%0.638
UTI1213%820%2015%0.271
Others1011%25%129%0.484
Unknown55%410%97%0.529
Table 3 Comparison of survivors and non-survivors
VariableNon-Survivors
Survivors
P value
mean ± SD
Min-Max
Median (Q1-Q3)
mean ± SD
Min-max
Median (Q1-Q3)
Age62.41 ± 14.6128-8266 (55.5-74.0)61.82 ± 14.5520-9264 (53.75-71.25)0.653
APACHE II23.93 ± 4.9114-3224 (20.5-28.0)21.08 ± 5.648-3321 (17.00-25.25)0.012a
SOFA score10.38 ± 4.712-1711 (6-15)8.81 ± 3.732-188 (6-11)0.094
HB12.2 ± 11.07.2-16.710 (8.8-12.0)10.6 ± 2.07.1-16.910.3 (9.1-12.0)0.493
TLC10.0 ± 6.90.2-24.38.5 (5.4-13.8)13.1 ± 8.60.1-46.511.9 (6.8-16.7)0.101
PLT1.99 ± 0.890.25-4.081.83 (1.58-2.01)2.18 ± 0.950.10-5.262.10 (1.65-2.78)0.188
SBIL1.02 ± 0.840.28-4.700.78 (0.57-1.27)2.00 ± 2.900.16-18.570.8 (0.5-2.0)0.489
SALB2.4 ± 0.41.6-3.12.3 (2.1-2.7)3.1 ± 0.61.5-4.43.1 (2.7-3.5)< 0.001a
INR1.28 ± 0.290.97-2.141.18 (1.09-1.31)1.36 ± 0.360.95-3.831.30 (1.12-1.48)0.099
CREAT2.08 ± 0.950.50-4.901.80 (1.50-2.40)1.36 ± 1.230.20-10.501.10 (0.60-1.80)< 0.001a
Urea61.24 ± 44.919.90-229.0045.60 (30.50-86.70)49.99 ± 31.303.30-168.9041.83 (30.10-61.60)0.280
HR107.00 ± 15.2270-128112 (98-118)104.34 ± 15.5864-156106.50 (94.00-116.00)0.228
SBP94.66 ± 22.8160-13890 (74-116)102.71 ± 21.4550-166102 (90-118)0.065
DBP52.41 ± 14.2126-8750 (41-60)58.77 ± 15.4124-9760.00 (46.00-69.25)0.060
MAP66.24 ± 16.6131-10167.0 (53.0-76.5)73.42 ± 15.7433-10671 (64-85)0.057
Lactate at 0 h5.20 ± 1.722.10-9.405.20 (4.0-5.70)4.74 ± 1.692.30-9.804.40 (3.40-5.90)0.151
Lactate at 3 h5.54 ± 2.142.40-10.705.20 (3.80-6.70)3.71 ± 1.801.30-12.403.40 (2.50-4.20)< 0.001a
Lactate at 6 h6.61 ± 3.352.10-14.606.30 (3.90-8.60)3.21 ± 2.700.60-16.702.45 (1.90-3.30)< 0.001a
CRT at 0 h5.07 ± 2.462-125 (3-7)4.07 ± 2.181-93 (2-6)0.040a
CRT at 3 h6.38 ± 2.952-136 (4-8)3.82 ± 2.141-103 (2-5)< 0.001a
CRT at 6 h7.10 ± 4.102-139 (3-11)3.63 ± 2.641-132.5 (2.0-5.0)< 0.001a
ScvO2 at 0 h68.30 ± 7.8043.20-73.9071.9 (70.2-72.8)66.20 ± 8.5042.80-74.2070.80 (58.90-71.90)0.033a
ScvO2 at 3 h61.90 ± 7.1045.80-73.5062.8 (58.9-66.2)61.00 ± 6.5036.80-73.7061.70 (57.80-64.90)0.304
ScvO2 at 6 h58.10 ± 11.8036.70-89.2058.9 (49.7-66.2)60.2 ± 7.6037.90-71.061.90 (56.10-65.90)0.299
P(cv-a)CO2 at 0 h6.50 ± 1.902.80-9.407.3 (4.9-7.9)5.70 ± 1.902.80-9.805.50 (4.20-7.40)0.036a
P(cv-a)CO2 at 3 h7.00 ± 2.103.40-12.306.5 (5.6-8.6)5.20 ± 1.602.7-11.04.8 (4.0-6.2)< 0.001a
P(cv-a)CO2 at 6 h7.10 ± 2.502.60-10.807.4 (4.9-9.2)5.40 ± 4.502.60-8.704.70 (3.60-5.80)< 0.001a
Lactate clearance at 3 h(-10.20 ± 35.10)(-88.10-40.40)(-8.6) (-37.1-24.7)18.80 ± 34.20(-183.30-58.20)26.80 (7.30-37.20)< 0.001a
Lactate clearance at 6 h(-28.70 ± 72.80)(-187.0-100.0)(-46.4) (-61.5-29.9)29.20 ± 64.40(-433.80-81.30)44.90 (23.40-58.70)< 0.001a
Table 4 Area under the curve to predict 28-d mortality for various perfusion markers at specified intervals
Test result variableAreaStd. ErrorP valueAsymptomatic 95%CI
Lower bound
Upper bound
Lactate at 0 h0.5870.0580.1330.4990.671
Lactate at 3 h0.7760.048< 0.001a0.6960.843
Lactate at 6 h0.8450.04< 0.001a0.7720.902
Lactate clearance at 3 h0.7540.053< 0.001a0.6720.824
Lactate clearance at 6 h0.8340.041< 0.001a0.760.893
CRT at 0 h0.6230.0560.028a0.5360.705
CRT at 3 h0.7680.047< 0.001a0.6880.837
CRT at 6 h0.7570.054< 0.001a0.6750.827
ScvO2 at 0 h0.6300.0620.035a0.5420.711
ScvO2 at 3 h0.5620.0640.3250.4740.648
ScvO2 at 6 h0.5650.0720.3670.4760.651
P(cv-a)CO2 at 0 h0.6270.0600.033a0.5400.709
P(cv-a)CO2 at 3 h0.7540.052< 0.001a0.6730.824
P(cv-a)CO2 at 6 h0.7360.060< 0.001a0.6520.808
Table 5 Cutoff values of perfusion markers at specified intervals
Marker
Cutoff value
Sensitivity
Specificity
PPV
NPV
Accuracy
P value
Lactate at 0 h> 4.955.2%63.2%29.1%83.8%61.5%0.074
Lactate at 3 h> 4.265.5%77.4%44.2%89.1%74.8%< 0.001a
Lactate at 6 h> 4.174.1%84.9%55.6%92.8%82.7%< 0.001a
Lactate clearance at 3 h≤ -20.6 (≥ 20.6% from baseline)44.8%93.4%65.0%86.1%83.0%< 0.001a
Lactate clearance at 6 h≤ -46.4 (≥ 46.4% from baseline)55.6%94.3%71.4%89.3%86.5%< 0.001a
CRT at 0 h> 455.2%67.9%32.0%84.7%65.2%0.022a
CRT at 3 h> 469.0%70.8%39.2%89.3%70.4%< 0.001a
CRT at 6 h> 851.9%94.3%70.0%88.5%85.7%< 0.001a
ScvO2 at 0 h> 71.755.2%71.7%34.8%85.4%68.2%0.007a
ScvO2 at 3 h> 61.769.0%53.8%29.0%86.4%57.0%0.03a
ScvO2 at 6 h≤ 58.955.6%65.1%28.9%85.2%63.2%0.05
P(cv-a)CO2 at 0 h> 7.644.8%81.1%39.4%84.3%73.3%0.004a
P(cv-a)CO2 at 3 h> 5.972.4%73.6%42.9%90.7%73.3%< 0.001a
P(cv-a)CO2 at 6 h> 6.463.0%83.0%48.6%89.8%79.0%< 0.001a
Table 6 Stepwise logistic regression to predict 28-d all-cause mortality
StepBS.E.Wald testdfSignificanceExp(B)
95%CI for Exp(B)
Lower
Upper
1aLactate at 6 hours0.3020.07317.23010.0001.3531.1731.561
Constant-2.7310.42142.11510.0000.065
2bCreatinine0.4160.1944.59510.0321.5151.0362.216
Lactate at 6 hours0.2950.07117.09110.0001.3441.1681.546
Constant-3.4160.55238.34810.0000.033