Articles: sepsis.
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To explore the relationship between serum levels of midkine and omentin-1 and the severity of sepsis in patients, and their prognostic value. A retrospective analysis was conducted on the clinical data of 180 sepsis patients. According to the severity of the patient's condition, they were separated into sepsis group (n = 76), severe sepsis group (n = 59), and sepsis shock group (n = 45). ⋯ The AUC of the combined prediction of serum Midkine and Ommentin-1 for the prognosis of sepsis patients was 0.880, with a sensitivity of 90.38% and a specificity of 72.66%. The combined prediction of serum Midkine and Ommentin-1 was better than that of individual prediction of Midkine and Ommentin-1. Serum Midkine is highly expressed and Omentin-1 is lowly expressed in sepsis patients, and the combination of the two has a high predictive power for the prognosis of sepsis patients.
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Background Sepsis is a life-threatening condition characterized by multiple organ dysfunction. Blood cells abnormalities play a significant role in the onset and progression of sepsis; however, the potential causal relationship between platelets and sepsis remains unclear, as does whether immune cells mediate the interaction between platelets and sepsis. This study aims to explore the potential causal relationship between platelets and sepsis and analyze the mediating effect of immune cells. ⋯ Monocytes and B cells mediate changes in the genetic association between platelets and sepsis. Monocytes and B cells primarily interact with platelets via the CLEC pathway, thereby modulating the genetic association between platelets and sepsis. These findings indicate that thrombocytopenia, especially when accompanied by elevated monocytes and B cells, may serve as a potential marker for sepsis.
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Aims/Background The role of heparin in sepsis therapy has been widely debated. The controversy surrounding heparin's use as an anticoagulant in sepsis may stem from differences in sepsis definitions, study designs, timing and dosage of drug administration, treatment duration, complications, and patient severity. In this study, we aimed to determine the optimal timing and dosage of heparin in patients with sepsis, identify specific subgroups that could benefit from heparin therapy, and explore laboratory markers to assess its efficacy. ⋯ The increase in platelet count had a significant mediating effect on the entire cohort (p < 0.001 for the causal mediation effect), with a mediation proportion of 14%. Conclusion Early and adequate heparin administration can significantly improve the prognosis of sepsis. An increase in platelet count may serve as a potential indicator of the effectiveness of heparin therapy in sepsis.
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Aims/Background Sepsis is a life-threatening condition resulting from dysregulated immune responses to infection, leading to organ dysfunction. High-density lipoprotein (HDL) and red cell distribution width (RDW) have shown significant correlations with sepsis severity, yet the combined prognostic value of HDL and RDW in evaluating sepsis severity and outcomes remains unclear. This study examines the relationship between HDL and RDW levels and sepsis severity, as well as evaluates the combined utility of these markers in predicting disease severity and patient outcomes. ⋯ Additionally, SOFA score (OR = 2.354), interleukin-6 (IL-6) (OR = 1.446), HDL (OR = 0.870), and RDW (OR = 3.502) were independent prognostic indicators (p < 0.05 for all). ROC analysis for prognosis showed that HDL combined with RDW had the highest predictive efficacy for the prognosis of sepsis, with an AUC of 0.922, sensitivity of 79.31%, and specificity of 93.24%. Conclusion The combination of HDL and RDW is a robust indicator for the evaluation of sepsis severity and is a valuable prognostic tool for assessing 30-day mortality risk in sepsis patients.
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Sepsis remains the leading cause of in-hospital death and one of the costliest inpatient conditions in the United States, while treatment delays worsen outcomes. We sought to determine factors and outcomes associated with a missed emergency physician (EP) diagnosis of sepsis. ⋯ This prospective single-academic center study identified patient subgroups at risk of impaired diagnostic accuracy of sepsis, with clinicians often overdiagnosing rather than underdiagnosing these groups. Prompt abnormal laboratory test results can "rescue" initial missed diagnoses, serving as potential clinician- and systems-level intervention points to reduce missed diagnoses. Missed diagnoses delayed antibiotics, but not mortality after controlling for severity of illness.