使用总血清轨迹识别新型急性胰腺炎亚现象
Chang-Li Li1, Xing-Chen Lin2, Meng Jiang3
1Department of FSTC Clinic, The First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
BMC gastroenterology
|April 23, 2024
概括
在急性胰腺炎 (AP) 中确定总血清 (TSC) 轨迹揭示了四种不同的患者亚表型. 这些模式与患者的治疗结果和住院死亡风险有显著的相关性.
科学领域:
- 关键护理医学 关键护理医学
- 生物化学 生物化学
- 医疗数据分析 医学数据分析
背景情况:
- 急性胰腺炎 (AP) 呈现出不同的临床特征,需要确定临床相关的亚表型.
- 纵向的全血清 (TSC) 轨迹为亚表型AP患者提供了潜在的途径.
研究的目的:
- 在住院的AP患者中识别新的亚现象型.
- 调查TSC轨迹与临床结果 (包括住院死亡率) 之间的关联.
主要方法:
- 利用美国的重症监护数据库 (MIMIC-III和MIMIC-IV),包括4518个AP入院.
- 应用基于组的轨迹建模,在住院后的前24小时内识别不同的TSC轨迹表型.
- 在已识别的TSC轨迹组中比较患者特征和治疗结果.
主要成果:
- 确定了四个TSC轨迹组:"非常低的TSC,缓慢的解决者" (1.4%),"中度低的TSC" (12.4%),"稳定的正常" (85.8%) 和"波动高的TSC" (0.4%).
- "非常低的TSC,缓慢的解决者"组表现出最差的临床指标 (例如,最高的SOFA得分,肌素,葡萄糖).
- "非常低的TSC,缓慢的解决者"",中度低的TSC"和"波动高的TSC"组与"稳定的正常"组相比,在医院死亡率显著更高.
结论:
- 在TSC轨迹的基础上,鉴定出了四种AP患者的新型亚表型.
- 绝对TSC水平及其随时间的动态变化都与AP的住院死亡率有显著的关联.
- 这些发现强调了监测TSC动态对于AP风险分层和结果预测的重要性.
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