在老年人群中纠正与电离的差异:一项观察性研究
Alexandra P S P Suryapranata1, Carolina J P W Keijsers1, Steef Kurstjens2
1Department of Geriatric Medicine, Jeroen Bosch Hospital, s- Hertogenbosch, the Netherlands.
Age and ageing
|April 12, 2024
概括
在三分之一的老年患者中,素调整后的总 (Ca-albumin) 和电离 (Ca-ionised) 测量结果之间存在差异. 这种错误分类在老年人和功能障碍患者中更为明显,影响了临床决策.
科学领域:
- 临床化学 临床化学
- 老年医学 老年医学
- 生物标志物测量 生物标志物测量
背景情况:
- 临床指南通常依赖于蛋白调整的总 (Ca-蛋白),尽管电离化 (Ca-电离化) 是黄金标准.
- 在Ca-albumin和Ca-ionised测量之间的差异可能导致临床困境,特别是在老年人群中.
- 这些差异在老年患者中的程度尚不清楚.
研究的目的:
- 在老年患者中调查Ca-电离和Ca-白蛋白测量之间的差异.
- 量化该人群中状况错误分类的比率.
- 确定差异最明显的患者子组.
主要方法:
- 在876名老年患者的观察性研究中,测量了Ca-电离和Ca-专蛋白.
- 对低血症和高血症的错误分类率的计算.
- 分析使用科恩的卡帕和使用皮尔森系数的相关性.
- 根据年龄和功能对效果变化的评估.
主要成果:
- 三分之一的测量结果显示状态的错误分类.
- 在28%的病例中,Ca-albumin未能发现低血症,在3.5%的病例中错过了高血症.
- 相关系数为0.743 (P=0.01),而科恩的卡帕是0.213 (P<0.001),表明协议不佳.
- 在85岁以上的患者 (Kappa=0.192) 和EGFR<30毫升/分钟/1.73平方米 (Kappa=0.104) 的患者中,一致性较低.
结论:
- 在老年患者的Ca-albumin和Ca-ionised测量之间存在显著差异,影响了三分之一的病例.
- 这些差异可能会导致临床困境,特别是在最老的老人和功能障碍患者中.
- 这些发现突出了Ca-albumin在准确反映脆弱老年人群中的状况方面的局限性.
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