在急性肺栓塞患者中,一种新的预后预测指标:那不勒斯预后得分
Ning Zhu1, Shanhong Lin2, Chao Cao3
1Department of Respiratory and Critical Care Medicine, Key Laboratory of Respiratory Disease of Ningbo, The First Affiliated Hospital of Ningbo University, 59 Liuting Road, Ningbo, 315010, Zhejiang, China.
Thrombosis journal
|November 7, 2023
概括
那不勒斯预后得分 (NPS) 有效预测急性肺栓塞 (APE) 患者的30天死亡率. 较高的NPS得分与死亡风险增加相关,有助于临床决策.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 医疗信息学 医疗信息学
背景情况:
- 急性肺栓塞 (APE) 是一种危及生命的疾病,需要立即评估风险.
- 准确的预后对于指导APE患者的治疗策略至关重要.
- 那不勒斯预后分数 (NPS) 是评估APE患者结果的潜在工具.
研究的目的:
- 评估那不勒斯预后得分 (NPS) 对急性肺栓塞 (APE) 诊断的住院患者30天全因死亡率的预测能力.
- 确定与NPS分层APE患者死亡风险增加相关的临床特征.
主要方法:
- 对325名患有APE的住院患者进行了回顾性分析.
- 根据患者的NPS,患者被分为三个组 (0,1,2).
- 三十天全因死亡率是主要结果;使用统计模型分析了临床数据和预后因素,包括考克斯比例危险和卡普兰-梅尔生存分析.
主要成果:
- 对于30天死亡率 (AUC = 0.780),NPS显示出良好的预测性表现.
- 较高的NPS组表现出明显增加的死亡风险 (P < 0.05),其中2组显示出最高的风险 (日志等级测试,P = 0.0004).
- 与较高死亡率相关的因素包括年龄较大,血压较低,低albuminemia,低胆固醇,中性粒细胞与淋巴细胞比率 (NLR) 升高,以及心脏右侧扩张的存在.
结论:
- 那不勒斯预后得分 (NPS) 是一种可靠的多维工具,用于预测急性肺栓塞 (APE) 患者的30天全因死亡率.
- NPS促进了风险分层,使临床医生能够识别高风险的APE患者,这些患者可能受益于加强管理.
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