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在急性危及生命的疾病中,医院前乳酸-葡萄糖相互作用:代谢反应和短期死亡率
Ricardo Usategui-Martín1,2, Daniel Zalama-Sánchez3, Raúl López-Izquierdo1,4,5
1Faculty of Medicine. University of Valladolid.
概括
乳酸盐可以预测短期死亡率,但高血糖会显著影响它的准确性. 血糖,而不是糖尿病,改变了乳酸的预测能力,有助于检测神秘冲击.
科学领域:
- 紧急医疗 紧急医疗
- 临床生物化学 临床生物化学
- 关键的护理关键的护理
背景情况:
- 乳酸盐是预测短期死亡率的已知生物标志物.
- 血糖和糖尿病对乳酸的预测准确性的影响需要进一步研究.
研究的目的:
- 评估低血糖,正常血糖和高血糖如何影响乳酸对3天死亡率的预测能力.
- 为了评估乳酸在糖尿病患者的预测性能.
主要方法:
- 涉及西班牙紧急医疗服务 (EMS) 和第三级护理医院 (2018-2022) 的前性,观察性,多中心研究.
- 包括寻求紧急援助的成年人.
- 主要结局:3天住院死亡率;预测因素:乳酸,血糖和糖尿病状况.
主要成果:
- 分析了6341名参与者;3天死亡率为3.5%.
- 乳酸盐对死亡率的预测能力在正常血糖 (AUC=0.897) 和高血糖 (AUC=0.819) 之间有显著差异.
- 糖尿病状态并没有显著改变乳酸在不同糖尿病分类中的预测能力.
结论:
- 血糖,特别是高血糖,显著改变了乳酸对短期死亡率的预测值.
- 糖尿病状态不会显著改变乳酸的预测性能.
- 考虑到血糖水平,特别是高血糖,可以提高使用乳酸盐水平选神秘的冲击条件.
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