血清自由甲状腺素水平与重症患者全因死亡率之间的关联:来自MIMIC-IV的回顾性研究
Juan-Juan Dai1, Ding-Fu Du2, Gang Ma1
1Department of Intensive Care Unit, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Frontiers in endocrinology
|June 12, 2023
概括
在重症患者中,低血清自由甲状腺素 (FT4) 水平与更高的30天死亡率有关. 低于1.2μg/dl的水平独立预测死亡风险,但更高的FT4也可能增加死亡率.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 临床化学 临床化学
背景情况:
- 危急病患者经常表现出低甲状腺素 (T4) 水平.
- 关于T4补充疗法存在有争议的发现.
- 血清自由T4 (FT4) 与危急疾病中的死亡率之间的关系需要澄清.
研究的目的:
- 调查血清FT4水平与严重病患者30天死亡率之间的关联.
- 确定FT4水平对重症监护室 (ICU) 死亡率的预测值.
主要方法:
- 来自MIMIC-IV数据库的数据分析.
- 卡普兰-梅尔曲线,线配合和受限立方线 (RCS) 分析.
- 后勤和考克斯回归模型,ROC曲线分析以评估FT4的预测价值.
主要成果:
- 分析了888名患者;FT4水平在30天死亡率上有显著差异.
- 较低的FT4水平 (<0.7μg/dl) 预测了30天死亡率 (OR=3.30).
- FT4水平<1.2μg/dl独立预测死亡率 (HR=0.34,OR=0.21),观察到V形关联.
结论:
- 血清FT4水平低于1.2μg/dl与危急病患者的30天死亡率增加显著相关,并预测30天死亡率增加.
- 更高的FT4水平也可能与30天死亡率的增加有关.
- FT4对死亡率的预测能力独立于其他混因素,但可能会受到T3或总T4水平的影响.
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