在接受关节骨折手术的老年患者中,预测1年死亡率的CRP/白蛋白比率
1Department of Anesthesiology and Reanimation, Faculty of Medicine, Malatya Turgut Özal University, Malatya Training and Research Hospital, Malatya, Turkey. ketamin2323@gmail.com.
European review for medical and pharmacological sciences
|October 2, 2023
概括
骨骨折后的C反应蛋白/白蛋白比率 (CAR) 可以预测骨折后的一年死亡率. 这一比率,以及C反应蛋白 (CRP) 和中性粒细胞/淋巴细胞比率 (NLR),可以帮助评估患者的风险.
科学领域:
- 老年医学 老年医学
- 整形外科手术 整形外科手术
- 临床病理学 临床病理学
背景情况:
- 骨折与高的一年死亡率有关,在现有文献中高达37.1%.
- 评估老年患者关节骨折后死亡风险对于临床管理至关重要.
- 炎症标志物越来越多地被认为是它们在各种疾病中的预后价值.
研究的目的:
- 调查C反应蛋白/白蛋白比率 (CAR) 是否是骨折后1年死亡率的独立预测指标.
- 评估CAR,中性粒细胞/淋巴细胞比率 (NLR),C反应蛋白 (CRP) 和蛋白水平在骨骨折后死亡率和发病率的预测能力.
主要方法:
- 在3年的时间里,对480名65岁以上的患者进行了分析,这些患者因关节骨折而接受了关节整形手术.
- 使用单变量和二进制逻辑回归分析来确定1年死亡率的预后因素.
- 使用接收器操作特征 (ROC) 分析来确定预测标记的最佳切断值.
主要成果:
- 在95名患者 (27.7%) 观察到1年的术后死亡率,平均年龄为85岁.
- 在1年死亡率 (AUC=0.843) 和ICU入院方面,CAR显示出强大的预测价值.
- 此外,CRP还显示出对死亡率的显著预测能力 (AUC=0.838),而NLR则预测了ICU入院 (最佳切断值6.64).
结论:
- 在老年骨骨折患者中,C-反应蛋白/白蛋白比率 (CAR) 是1年死亡率和术后ICU入院的重要独立预测指标.
- 中性粒细胞/淋巴细胞比率 (NLR) 是术后ICU入院的预测指标.
- 这些炎症标志物为关节骨折患者的风险分层和管理提供了宝贵的见解.
相关概念视频
01:24Serum Studies: Renal Function Tests
9
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
9
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
21
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
21
01:22Acute Kidney Injury I: Introduction
15
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
15