在患有严重高血血症的患者中,正率和全因死亡率
Eugene Feigin1,2,3, Libi Feigin3, Merav Ingbir1,3,4
1Internal Medicine Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
JAMA network open
|September 28, 2023
概括
在住院患者中,严重高血的快速纠正与较低的死亡率和较短的住院时间有关. 这挑战了当前的指导方针,表明更快的利率可能是安全和有益的.
科学领域:
- 内部医学 内部医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
背景情况:
- 过血症在住院患者中很常见,并与高死亡率有关.
- 目前的指导方针建议对高血的纠正速度缓慢,但证据有限.
研究的目的:
- 为了研究超血病正率与患者存活率之间的关联.
- 为了评估不同高血纠正率的安全性和有效性.
主要方法:
- 对4265名患有严重高血症 (血清含量≥155 mmol/L) 的患者进行了回顾性队列研究.
- 根据正率分组患者:快速 (>0.5 mmol/L/h) 与缓慢 (≤0.5 mmol/L/h).
- 主要结局是全因30天死亡率;次要结局包括住院时间和神经系统并发症.
主要成果:
- 快速校正与显著较低的30天死亡率 (31.8%与50.7%,P<.001) 和较短的住院时间 (中位数5.0与7.2天,P<.001) 相关.
- 这些发现在调整多个混因素后仍然存在.
- 两组之间没有观察到神经系统并发症的显著差异.
结论:
- 严重高血的快速纠正似乎是安全的,并且与改善的生存率和减少住院时间有关.
- 医生应该重新考虑当前的指导方针,并根据全面的证据考虑更快的纠正率.
- 进一步的研究可能是有必要的,以建立最佳的高血纠正策略.
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