Baseline Characteristics of Enrolled patients.

IntroductionSepsis is a life-threatening condition, especially for patients in the intensive care unit (ICU), where early identification of the prognosis is critical. This study aimed to evaluate the prognostic value of inflammatory markers, clinical scores, and specific laboratory findings for predicting ICU and in-hospital mortality in sepsis patients.MethodsA retrospective cohort study was conducted on adult patients with sepsis who were admitted to the ICU of a university hospital between September 2019 and December 2022. To minimize selection bias, all eligible patients during the study period were consecutively included. Data were extracted from electronic medical records and included demographics, clinical characteristics, inflammatory markers, and clinical scores such as the Charlson Comorbidity Index (CCI), Clinical Frailty Scale (CFS), Eastern Cooperative Oncology Group (ECOG) performance status, Simplified Acute Physiology Score 3 (SAPS 3), and Sequential Organ Failure Assessment (SOFA). The primary outcomes were ICU and in-hospital mortality. Univariate and multivariate Cox regression analyses were performed to identify predictors of mortality.ResultsA total of 213 ICU patients with sepsis were included in the study. The patients were 62.0% male with a mean age of 73.1 ± 12.6 years. The ICU and in-hospital mortality rates were 29.6% and 36.6%, respectively. Non-survivors had higher clinical severity scores and poorer nutritional and perfusion profiles than survivors. Multivariate analysis revealed that elevated lactate levels (a marker of tissue hypoperfusion) and higher SAPS 3 scores were independently associated with ICU mortality. For in-hospital mortality, lower albumin levels and higher SAPS 3 scores were significant predictors.ConclusionsHigh lactate and SAPS 3 scores were independent predictors of mortality, while higher albumin levels showed a potential protective effect. Early identification of these factors may aid in the management of sepsis.引言 脓毒症（Sepsis）是一种危及生命的病症，尤其对于重症监护病房（Intensive Care Unit, ICU）内的患者而言，早期识别其预后至关重要。本研究旨在评估炎症标志物、临床评分及特定实验室检查结果在预测脓毒症患者ICU及住院死亡率中的预后价值。方法 本研究为一项回顾性队列研究，研究对象为2019年9月至2022年12月期间，于某大学附属医院ICU收治的成年脓毒症患者。为最大限度减少选择偏倚，研究期间所有符合纳入标准的患者均被连续纳入研究。数据从电子病历中提取，涵盖人口统计学资料、临床特征、炎症标志物以及各类临床评分，包括查尔森合并症指数（Charlson Comorbidity Index, CCI）、临床衰弱量表（Clinical Frailty Scale, CFS）、东部肿瘤协作组体能状态评分（Eastern Cooperative Oncology Group performance status, ECOG）、简化急性生理学评分3（Simplified Acute Physiology Score 3, SAPS 3）以及序贯器官衰竭评估评分（Sequential Organ Failure Assessment, SOFA）。本研究的主要结局指标为ICU死亡率及住院死亡率。采用单因素及多因素Cox回归分析筛选死亡率预测因素。结果 本研究共纳入213例ICU脓毒症患者。其中男性占比62.0%，平均年龄为73.1±12.6岁。ICU及住院死亡率分别为29.6%与36.6%。非存活患者的临床严重程度评分更高，营养状态及灌注指标较存活患者更差。多因素分析显示，乳酸水平升高（组织低灌注标志物）及较高的SAPS 3评分与ICU死亡率独立相关。针对住院死亡率而言，低白蛋白水平及较高的SAPS 3评分是显著的预测因素。结论 高乳酸水平与SAPS 3评分是死亡率的独立预测因素，而较高的白蛋白水平则显示出潜在的保护作用。早期识别这些因素可为脓毒症的临床管理提供辅助支持。