A study on the correlation of extravascular lung water index and blood lactate clearance rate with the prognosis of patients with sepsis

Objective: To explore the clinical significance of dynamic changes in extravascular lung water index (EVLWI) and blood lactate clearance rate (LCR) in assessing the prognosis in patients with sepsis. Methods: The clinical data of 81 patients with sepsis receiving treatment in our hospital from January 2016 to January 2017 were analyzed retrospectively. The patients were divided into survival group and death group according to the survival condition on the 28th day after they were diagnosed with sepsis. The dynamic changes in EVLWI and LCR on the 1st day, the 2nd day and the 3rd day of the two groups of patients were analyzed to evaluate the clinical values of EVLWI and LCR in assessing the prognosis in patients with sepsis. Results: Among the 81 patients with sepsis included in this study, 47 patients survived and 34 patients died on the 28th day after they were clearly diagnosed with sepsis. The difference in basic information between the survival group and the death group was not statistically significant (P>0.05). EVLWI in the survival group was lower than that in the death group, while the LCR in the survival group was higher than that in the death group. The differences were statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that EVWLI and LCR on the 3rd day after the patients were admitted to intensive care units (ICU) were the factors affecting the prognosis in the patients (P<0.001). The correlation analysis showed that the two indexes were negatively correlated (P<0.001). The analysis of receiver operating characteristic (ROC) curves indicated that when 9.29 mL/kg was taken as the threshold of EVLWI, the sensitivity was 91.2%, and the specificity was 83.0%; when 10.98 was taken as the threshold of LCR, the sensitivity was 95.7%, and the specificity was 85.3%. The sensitivity of the two combined indexes was 93.6%, and the specificity of them was 88.2%. Conclusion: The dynamic changes in EVLWI and LCR are closely related to the prognosis in patients with sepsis.