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| Predictive value of sequential organ failure assessment score for red blood cell transfusion in patients with sepsis |
| Wu Yan-Li, Xing Bo |
| Department of Emergency, the Second Affiliated Hospital of Hainan Medical Univemity, Haikou 570311, China |
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Abstract Objective To explore the predictive value of sequential organ failure assessment (SOFA) score for red blood cell (RBC) transfusion in patients with sepsis. Methods Patients with sepsis admitted to the emergency department of the Second Affiliated Hospital of Hainan Medical College from March 2016 to March 2019 were enrolled. The patients were divided into two groups according to whether RBC was transfused or not within 7 days. Gender, age, body mass index (BMI), hemoglobin (Hb), albumin (ALB), serum creatinine (SCr), ferritin (FER), vitamin B12, folic acid (FOL), erythropoietin (EPO), blood loss and SOFA score were compared between the two groups. Logistic regression was used to analyze the risk factors of RBC transfusion in patients with sepsis, and the predictive value of each index for RBC transfusion in patients with sepsis was evaluated by Receiver Operating Characteristic (ROC) curve. Results A total of 71 patients with sepsis were enrolled. Among them, 32 (45.1%) received RBC transfusion (RBC transfusion group), and 39 (54.9%) did not receive RBC transfusion (non-RBC transfusion group). There was no significant difference in gender, age and BMI between the two groups (P＞0.05). Compared with the non-RBC transfusion group, SOFA score, blood loss and FER in the RBC transfusion group increased significantly ［SOFA score (score): 13.5±4.3 vs. 8.6±3.4, t=-5.009, P=0.000; blood loss (mL): 258.0 (177.8,369.4) vs. 184.0 (156.1,257.9), t=-4.536, P=0.000; FER (ng/mL): 799.0 (404.9,2768.1) vs. 325.7 (163.9,918.8), t=-2.966, P=0.003］, Hb and ALB decreased significantly ［Hb (g/L): 102.4±29.1 vs. 118.9±19.6, t=2.618, P=0.011; ALB (g/L): 23.2±5.8 vs. 26.6±7.1, t=2.180, P=0.033］, while SCr, EPO, FOL and vitamin B12 showed no significant difference (P＞0.05). Univariate analysis showed that SOFA score, Hb, ALB and FER were correlated with RBC transfusion in patients with sepsis (all P＜0.05). Multivariate Logistic regression analysis showed that SOFA score and blood loss were independent risk factor for RBC transfusion in patients with sepsis (SOFA score: OR 1.334, 95%CI1.093~1.628, P=0.005; blood loss: OR 1.007, 95%CI1.001~1.014, P=0.018). ROC curve analysis showed that the area under ROC curve (AUC) of SOFA score, Hb, ALB and FER for predicting RBC transfusion in patients with sepsis were 0.812 (95%CI0.711~0.913, P=0.000), 0.704 (95%CI0.576~0.831,P=0.033), 0.653 (95%CI0.518~0.789,P=0.004) and 0.713 (95%CI0.588~0.837, P=0.003) respectively. The AUC of SOFA score was significantly greater than that of Hb, ALB and FER (Z=6.724, P=0.012) . When the cut-off value of SOFA score was 10, the sensitivity, specificity, positive predictive value and negative predictive value were 76.2%, 75.0%, 71.4% and 69.2%, respectively. Conclusion The SOFA score is closely related to RBC transfusion in patients with sepsis, and has a high predictive value for RBC transfusion in patients with sepsis.
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Corresponding Authors:
Xing Bo, E-mail：xb36370887@163.com
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