在烧伤患者中,AKI和AKIN严重程度的开创性预测:全面的CBC方法
Jongsoo Park1, Dohern Kym2,3, Myongjin Kim1
1Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 12, Beodeunaru-ro 7-gil, Youngdeungpo-gu, Seoul, 07247, South Korea.
Scientific reports
|January 5, 2024
概括
全血细胞计 (CBC) 标志物显示出早期急性损伤 (AKI) 检测和烧伤患者的死亡率预测的前景. 常规CBC测试提供了一种具有成本效益的工具,可以改善AKI管理和患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
背景情况:
- 急性损伤 (AKI) 是烧伤患者的重大并发症,需要有效的诊断和预后工具.
- 现有的AKI诊断方法在早期检测和严重程度评估方面可能存在局限性,特别是在资源有限的环境中.
- 完整血清 (CBC) 参数是常规可用的和具有成本效益的,这表明在管理AKI方面具有潜在的实用性.
研究的目的:
- 评估完整血清 (CBC) 标志物的有效性,用于早期检测,严重程度评估和预测AKI烧伤患者的死亡率.
- 评估各种CBC衍生比率 (例如中性粒细胞与淋巴细胞比率) 与AKI严重程度之间的相关性.
- 验证CBC作为常规诊断工具的成本效益和实用性,用于在烧伤重症监护室管理AKI.
主要方法:
- 在12年内对2758名成年烧伤重症监护室患者进行了大规模的回顾性分析.
- 根据急性损伤网络 (AKIN) 标准对患者进行分类.
- 使用R编程语言进行统计分析,以评估CBC标记物 (包括NLR,PLR,SII,MPV等比率) 与AKI结果之间的相关性.
主要成果:
- 急性损伤 (AKI) 发生在56.3%的被研究的烧伤患者中.
- 白血细胞 (WBC) 计数 (AUC 0.793) 和中性粒细胞计数 (AUC 0.790) 证明了AKI的高诊断效用.
- 中性粒细胞与淋巴细胞的比率 (NLR) 在AKI严重程度和死亡率预测的比率标志物中显示出最高的AUC (0.772).
结论:
- 全血细胞计数 (CBC) 标志物,特别是WBC计数和中性细胞与淋巴细胞比率 (NLR),对于早期AKI检测和烧伤患者的死亡率评估非常有价值.
- 这些发现支持使用常规CBC测试作为一种经济和可访问的工具,以加强在烧伤护理中的AKI管理.
- 建议进行进一步的多中心验证研究,以确认这些基于CBC的预测模型的广泛适用性.
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