The dyslipidemia and changes in D-dimer values that occur in children with severe sepsis remain unidentified. The current research aimed to explore the relationship between D-dimer and lipid profile values, including total cholesterol (TC), lipoproteins, apolipoprotein A-V (Apo A-5), triglycerides (TG), and in-hospital nonsurvival in children with severe sepsis or septic shock in pediatric intensive care. The study design is as follows: prospective cohort study. Children with severe sepsis or septic shock who were admitted to the intensive care unit of a university pediatric hospital. Vital signs, sepsis assessment, pediatric sequential organ failure assessment (PSOFA) score, high-density lipoprotein (HDL), Apo A-5, TG, low-density lipoprotein (LDL), TC, D-dimer, mortality outcome, and pediatric risk of mortality (PRISM) III score were evaluated. The primary outcome was in-hospital nonsurvival. The nonsurvivors had significantly higher D-dimer levels than the survivors, with a significant cutoff level of 0.87 μg/mL (AUC: 0.85, sensitivity: 93.3%, PVN: 90.6%, accuracy: 79.0%, PVP: 72.5%, and specificity: 64.7%). D-dimer was inversely correlated with WBC count and positively correlated with patient age, PRISM III score, PSOFA score, and INR. However, nonsurvivors had higher TG levels and lower TC, HDL, LDL, and Apo A-5 levels than survivors, but this variation was insignificant. Apo A-5 levels were inversely correlated with HDL and positively correlated with TG levels. This study suggests that D-dimer is a promising biomarker for severe sepsis in children, with a mortality cutoff level of 0.87 μg/mL. However, lipid profiles are not predictors of sepsis-related mortality.

中文翻译：

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儿童严重脓毒症引起的血脂异常和 D-二聚体水平变化的前瞻性队列研究：它们会影响预后吗？

严重败血症儿童中发生的血脂异常和 D-二聚体值的变化仍不清楚。目前的研究旨在探讨严重脓毒症儿童的D-二聚体与血脂谱值之间的关系，包括总胆固醇（TC）、脂蛋白、载脂蛋白AV（Apo A-5）、甘油三酯（TG）和院内非存活率或儿科重症监护中的感染性休克。研究设计如下：前瞻性队列研究。患有严重脓毒症或脓毒性休克，入住大学儿科医院重症监护室的儿童。生命体征、败血症评估、儿科序贯器官衰竭评估 (PSOFA) 评分、高密度脂蛋白 (HDL)、Apo A-5、TG、低密度脂蛋白 (LDL)、TC、D-二聚体、死亡率结果和儿科评估死亡风险（PRISM）III评分。主要结局是院内无生存。非幸存者的 D-二聚体水平显着高于幸存者，显着截止水平为 0.87 μg/mL（AUC：0.85，敏感性：93.3%，PVN：90.6%，准确性：79.0%，PVP：72.5%，特异性：64.7%）。D-二聚体与 WBC 计数呈负相关，与患者年龄、PRISM III 评分、PSOFA 评分和 INR 呈正相关。然而，与幸存者相比，非幸存者的 TG 水平较高，TC、HDL、LDL 和 Apo A-5 水平较低，但这种差异并不显着。Apo A-5 水平与 HDL 呈负相关，与 TG 水平呈正相关。这项研究表明，D-二聚体是儿童严重脓毒症的一种有前途的生物标志物，死亡率截止水平为 0.87 μg/mL。然而，血脂谱并不能预测脓毒症相关死亡率。