临床上显著出血的预测因子 血小板的登革热患者入住重症监护室:一项回顾性研究
Priya Logia1, Velmurugan Selvam1, Vetriselvan Parasuraman2
1Department of Critical Care Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
概括
登革热患者的临床显著出血 (CSB) 预测是高温,激活部分血栓形成时间 (aPTT) 升高和序列器官功能评估 (SOFA) 得分增加. 一个简单的评分系统可以识别有风险的患者.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 临床研究 临床研究
背景情况:
- 登革热患者的有效管理需要早期识别临床显著出血 (CSB).
- 预测CSB对于及时干预和改善患者结果至关重要.
- 血小板缺血是登革热的常见并发症,增加出血风险.
研究的目的:
- 在ICU的成年登革热患者中确定CSB的预测因子.
- 开发一个简单的临床评分系统来预测CSB.
- 为了比较登革热患者的出血度和血栓塞缩症严重程度.
主要方法:
- 从2015年至2021年接受ICU治疗的成年登革热患者的回顾性研究.
- 在入院时收集人口,临床和实验室变量.
- 单变量和多变量分析以确定CSB的独立风险因素.
主要成果:
- 在120名血栓塞性登革热患者中,38名 (31.6%) 患有CSB.
- CSB的独立预测因素包括温度>38.3°C,激活部分血栓形成时间 (aPTT) 升高>40秒,以及更高的序列器官功能评估 (SOFA) 得分.
- 预测得分显示,CSB检测的灵敏度为81%,特异性为77% (AUC:0.81).
结论:
- 温度>38.3°C,aPTT升高和SOFA得分增加是登革热患者中CSB的独立风险因素.
- 结合这些因素的临床预测得分可以有效地识别患有CSB风险的患者.
- 这一分数有助于早期识别和管理严重的登革热并发症.
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