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Predicting short‐term and long‐term mortalities from sepsis in patients who receive allogeneic haematopoietic stem cell transplantation

医学 败血症 造血干细胞移植 内科学 队列 移植 多元分析 器官功能障碍 重症监护室 重症监护医学
作者
Yejun Wu,Hui‐Xin Liu,Xiaolu Zhu,Haixia Fu,Yun He,Feng‐Rong Wang,Yuanyuan Zhang,Xiao‐Dong Mo,Wei Han,Jingzhi Wang,Yu Wang,Huan Chen,Yu‐Hong Chen,Xiang‐Yu Zhao,Ying‐Jun Chang,Lan‐Ping Xu,Kai‐Yan Liu,Xiao‐Jun Huang,Xiaohui Zhang
出处
期刊:British Journal of Haematology [Wiley]
卷期号:202 (2): 344-355 被引量:2
标识
DOI:10.1111/bjh.18835
摘要

Summary Patients who receive allogeneic haematopoietic stem cell transplantation (allo‐HSCT) may develop sepsis, which result in a highly intensive care unit admission rate and mortality. Therefore, short‐term and long‐term prognostic models for sepsis after allo‐HSCT are urgently needed. We enrolled patients receiving allo‐HSCT who developed sepsis after allo‐HSCT at Peking University People's Hospital between 2012 and 2021, including 287 patients who received allo‐HSCT in 2018–2021 in the derivation cohort, and 337 patients in 2012–2017 in the validation cohort. Multivariate logistic regression analysis was used to identify prognostic factors, and these identified factors were incorporated into two scoring models. Seven independent factors (acute graft‐versus‐host disease (GVHD), chronic GVHD (cGVHD), total bilirubin, lactate dehydrogenase (LDH) and organ dysfunction [renal, lung and heart]) were included in the 6‐month prognostic model, and six factors (cGVHD, C‐reactive protein, LDH, organ dysfunction [lung, neurologic and coagulation]) were included in the 14‐day prognostic model. The area under the receiver operating characteristic curves, calibration plots and decision curve analysis demonstrated the robust predictive performance of the models, better than the Sequential Organ Failure Assessment score. Early identification of patients with high risk of 6‐month and 14‐day death may allow clinicians to provide timely treatments and improve the therapeutic effects.
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