Objective To investigate the value of dynamic monitoring serum high mobility group box-1 (HMGB1) and glucose-regulated protein 78 (GRP78) levels in predicting the prognosis of sepsis patients.
Methods A total of 208 sepsis patients were selected as the study subjects. Based on the 28-day survival outcomes, the patients were divided into good prognosis group and poor prognosis group. General data, serum HMGB1 and GRP78 levels were compared between the two groups. Logistic regression analysis was used to screen for the influencing factors of the prognosis of sepsis patients. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of serum HMGB1 and GRP78 levels for patient prognosis.
Results On the 0th, 3rd and 7th days of admission, the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores, as well as serum HMGB1 and GRP78 levels were higher in the poor prognosis group than those in the good prognosis group, with statistically significant differences (P < 0.05 or P < 0.001). On the 0th, 3rd and 7th days of admission, HMGB1 and GRP78 were positively correlated with the APACHE Ⅱ score (P < 0.05). On day 0 of admission, serum HMGB1 and GRP78 levels, as well as the APACHE Ⅱ score, were all influencing factors for the prognosis of sepsis patients (P < 0.05). On the 0th, 3rd and 7th days of admission, the area under the curve (AUC) values for predicting poor prognosis in sepsis patients using the combination of HMGB1 and GRP78 were 0.901, 0.819 and 0.782, respectively, with the highest predictive AUC on day 0 of admission (P < 0.05).
Conclusion HMGB1 and GRP78 are independent influencing factors for poor prognosis in sepsis patients. Dynamic monitoring of their levels is of clinical significance, with the highest predictive value on day 0 of admission, which can serve as an important auxiliary reference for early identification of high-risk sepsis patients.
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