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Objective: By evaluating the level of serum procalcitonin (PCT), thromboelastography (TEG) and platelet count (PLT) of patients with septic shock in intensive care unit (ICU), the predictive value of the combination of the three indicators on the short-term progression was discussed, which provided a new basis for early clinical diagnosis and disease evaluation. Methods: The clinical data of 130 patients with septic shock admitted to the IUC of our hospital from December 2021 to December 2023 were analyzed retrospectively. These subjects were divided into good prognosis group (n=78) and poor prognosis group (n=52) according to the 28 d deaths. The influencing factors were explored using the Multivariate logistic regression analysis. The value of single or combined PCT, PLT and TEG in predicting poor short-term prognosis was assessed using the receiver operating characteristic (ROC) curve. Results: The patients in poor prognosis group had higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, serum PCT level, coagulation reaction time (R value) and coagulation formation time (K value), but lower PLT levels, final strength of coagulation (MA value) and coagulation formation rate (α angle) than those in good prognosis group (P<0.001). PCT, R value and K value were risk factors (P<0.001), while PLT, MA value and α angle were protective factors (P<0.001). The area under the curve (AUC) of PCT, PLT and TEG predicting poor short-term progression was 0.813, 0.658 and 0.752, respectively. The AUC of combined three indicators was 0.905, which had the highest predictive value. Conclusion: Serum levels of PCT, PLT and TEG had certain value in predicting poor short-term progression of septic shock patients, and their combined diagnostic value was higher. Therefore, regular monitoring of these three indicators could provide certain guiding significance for the prevention and treatment of poor short-term prognosis in patients with septic shock.
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BACKGROUND: Severe traumatic brain injuries (STBIs) cause 1/3-1/2 of trauma-related deaths. Tumor necrosis factor (TNF) receptor-associated factor NF-κB activator (TANK)-binding kinase 1 (TBK1) is a biomarker associated with inflammation, while inflammation is a key promoter of the TBI process. OBJECTIVES: To investigate the clinical significance of TBK1 in STBI patients. MATERIAL AND METHODS: The present prospective observational study included a total of 95 STBI cases diagnosed from October 2019 to October 2021. The values for optic nerve sheath diameter (ONSD) were determined under deep sedation using 2-dimensional gray scale ultrasound. Intracranial pressure (ICP) was also measured. Serum levels of TBK1 and inflammatory factors such as C-reactive protein (CRP), interleukin (IL)-1ß and IL-6 were evaluated with enzyme-linked immunosorbent assay (ELISA). Clinical variables including pathological type, Glasgow Coma Scale (GCS) score, sequential organ failure assessment (SOFA) score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were recorded. RESULTS: The levels of TBK1 in the deceased patients were remarkably lower than in the patients who survived. The IL-1ß and IL-6 were markedly elevated in deceased patients compared with survivors, and negatively correlated with serum levels of TBK1. The ONSD and ICP values were significantly higher in the deceased patients than in the patients who survived and were positively correlated with each other, while both were negatively correlated with TBK1 levels. Patients with lower TBK1 expression showed significantly lower GCS scores, higher SOFA and APACHE II scores, as well as a higher 1-month mortality rate. The Kaplan-Meier curve showed that patients with higher TBK1 levels had a higher 1-month survival rate compared with the patients with lower TBK1 levels. Only TBK1 and ONSD were independent risk factors for 1-month mortality in STBI patients. CONCLUSIONS: Lower serum TBK1 levels are associated with higher inflammatory factors, higher ONSD and ICP levels, as well as a poorer prognosis in STBI patients.