Predictive value of heparin-binding protein plus extravascular lung water index for prognosis of patients with sepsis-related acute respiratory distress syndrome

This study aimed to investigate the predictive value of heparin-binding protein (HBP) combined with extravascular lung water index (EVLWI) for the prognosis of patients with sepsis-related acute respiratory distress syndrome (ARDS). A total of 156 patients with sepsis-related ARDS admitted from October 2019 to December 2021 were selected and divided into a survival group and a death group based on clinical outcomes. The predictive value of HBP and EVLWI was analyzed using the receiver operating characteristic (ROC) curve. The optimal subset of prognostic predictors was obtained by LASSO regression with 10-fold cross-validation, and independent risk factors were determined via logistic regression analysis. A nomogram prediction model was then established, and its performance was evaluated in terms of discrimination and calibration. After adjusting for confounders, the risk of poor prognosis increased by 14% for each 2 mg/L rise in HBP when HBP was ≥28.56 mg/L (OR=0.92, 95%CI: 0.88-0.98, P<0.05), and by 17% for each 1 mL/kg increase in EVLWI when EVLWI was ≥12.91 mL/kg (OR=0.80, 95%CI: 0.68-0.94, P<0.05). The AUCs of HBP and EVLWI for predicting poor prognosis were 0.805 and 0.785, respectively, while their combination demonstrated superior diagnostic efficacy. Furthermore, EVLWI, PVPI, hs-CRP, PCT and HBP were identified as independent risk factors (P<0.05). The nomogram prediction model exhibited high discrimination and accuracy. The combination of HBP and EVLWI serves as a sensitive and reliable prognostic indicator in patients with sepsis-related ARDS, with high predictive value for clinical outcomes