血清TSH水平与危急病患者全因死亡率之间的关联
Wenwen Sun1, Chaoqun Xu2, Yulian Zhang3
1Department of Intensive Care Unit, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China.
甲状腺刺激激素 (TSH) 水平显示了严重病患者的死亡率与U形相关性. 低水平和高水平的TSH都会增加死亡风险,这表明TSH是预后的关键生物标志物.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 医疗信息学 医疗信息学
背景情况:
- 甲状腺功能障碍在严重疾病中普遍存在,并影响患者的治疗结果.
- 甲状腺刺激激素 (TSH) 在严重疾病中的预后价值尚未得到充分确立.
研究的目的:
- 研究TSH水平与重症患者的临床预后之间的关系.
- 为了确定TSH是否可以作为在重症监护室 (ICU) 设置中的风险分层的生物标志物.
主要方法:
- 来自MIMIC-IV数据库的6432名ICU患者的回顾性分析.
- 患者被分为四个TSH四分位数;通过7日,30日和90日死亡率评估结果.
- 统计分析包括限制立方线,卡普兰-梅尔曲线和考克斯回归模型.
主要成果:
- 在TSH水平和7日,30日和90日死亡率之间发现了一个U形的关联 (P<0.05为非线性).
- 与参考组 (Q3) 相比,低 (Q1,Q2) 和高 (Q4) TSH水平与30天死亡风险增加有关.
- 高TSH (Q4) 也与90天死亡率的增加有关;子组分析显示基于性别和年龄的差异性风险.
结论:
- TSH水平与重症患者的短期和中期死亡率有显著的关联.
- TSH显示出作为一个有价值的生物标志物的潜力,用于预测ICU人群的预后和分层风险.
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