尿素与肌素的比率作为持续严重疾病的预测指标
Liran Statlender1, Tzippy Shochat2, Eyal Robinson1
1Department of General Intensive Care, Rabin Medical Centre, Beilinson Hospital, Petah Tikva, Israel; School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Journal of critical care
|May 23, 2024
概括
尿素与肌素的比率 (UCr) 并没有预测ICU患者的持续性严重疾病 (PCI) 的发展. 然而,UCr和PCI的升高与1年死亡率的增加有关,这突显了它们的预后意义.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床流行病学临床流行病学
背景情况:
- 持久性危急性疾病 (PCI) 的特点是长时间的ICU停留时间 (>10天) 和显著的患者负担.
- 尿素与肌素的比率 (UCr) 已被提出作为一种潜在的早期标志物,用于识别患有PCI风险的患者.
- 了解PCI的预测因素对于改善患者的治疗结果和重症监护病房的资源配置至关重要.
研究的目的:
- 调查尿素与肌素比率 (UCr) 与持久性严重疾病 (PCI) 的发展之间的联系.
- 评估UCr和PCI在1年死亡率方面的预后价值.
- 在危急疾病的背景下分析患者子组和KDIGO阶段的UCr差异.
主要方法:
- 一项回顾性,单中心研究包括2098名患者,他们在2018年至2022年期间入院于一般混合医疗外科ICU.
- 收集的数据包括人口统计,基线特征,每日UCr,置换疗法 (RRT),停留时间 (LOS) 和死亡率.
- 统计分析包括费舍尔精确测试,奇方,重复测量线性模型和多变量考克斯回归.
主要成果:
- PCI患者年龄较大,入院预后得分较高,90天死亡率明显较高 (34.58%对12.18%).
- 在所有患者中,只有在第一天入院时才观察到UCr的显著差异,而不是在特定的子组或KDIGO阶段.
- 升高的UCr和PCI都与1年死亡率的增加显著相关.
结论:
- 尿素与肌素的比率 (UCr) 在这个队列中没有发现与持续性严重疾病 (PCI) 的发展有关.
- 尽管不预测PCI发展,但UCr和PCI状态是长期死亡风险的重要指标.
- 可能需要进一步的研究来确定可靠的PCI早期标志物.
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