作为预后指标的败血症患者在前24小时内乳酸水平的动态变化:使用潜阶级生长分析进行回顾性队列研究
Shifeng Li1, Tao You2, Meili Liu1
1Department of Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Biomolecules & biomedicine
|July 24, 2023
概括
败血症患者的动态乳酸变化显著影响预后. 在24小时内乳酸水平上升表明与稳定的水平相比,临床状况更差,死亡风险更高.
科学领域:
- 关键护理医学 关键护理医学
- 生物医学数据科学 生物医学数据科学
背景情况:
- 乳酸盐水平升高是败血症患者的常见指标.
- 了解动态乳酸变化对于预测败血症患者的结果至关重要.
研究的目的:
- 为了评估动态乳酸盐水平变化的预后影响,在第一个24小时内入院后的败血症患者.
- 将败血症患者根据乳酸水平轨迹使用隐性类增长分析 (LCGA) 将其分为不同的组.
主要方法:
- 利用MIMIC-IV数据库,从7,830名败血症患者中提取数据.
- 应用LCGA根据四个定义的时间段 (0-3h,3-6h,6-12h,12-24h) 的最高乳酸水平对患者进行分类.
- 在确定的患者类别之间比较基线特征和临床结果.
主要成果:
- LCGA成功地确定了两个患者类:一个"稳定乳糖类"和一个"增加乳糖类".
- "乳酸类增加"呈现出较差的基线临床状态,包括生命体征,疾病严重程度得分和实验室结果.
- 与"稳定乳酸类" (13.5%,P < 0.001) 相比",增加乳酸类"的28天死亡率 (55.6%) 显著更高.
结论:
- LCGA是一种有效的方法,用于根据24小时内乳酸水平的动态变化对败血症患者进行分类.
- 乳酸水平轨迹是败血症患者预后的重要预测因素.
- 这种分类方法可能为败血症患者的治疗提供临床实用性.
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