一项回顾性观察性研究,评估了血管活性-异位热量得分和腹部重大手术后的死亡率之间的关联
Jiao Huang1, Jiemei Ji1, Yang Zhao2
1Department of Anesthesiology, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China.
Scientific reports
|July 8, 2024
概括
在ICU入院后24小时内增加最大血管活性-异位积分 (VISmax) 会增加主要腹部手术患者的死亡风险. 较高的VISmax与明显更高的30天和1年的全因死亡率有关.
科学领域:
- 关键护理医学 关键护理医学
- 外科手术的结果
- 药理学 药理学是指药理学的学科.
背景情况:
- 大型腹部手术后最大血管活性 - 异位积分 (VISmax) 和死亡率之间的关系还不清楚.
- 血管活性剂和内类药物对于重症患者的血液动力学管理至关重要.
研究的目的:
- 调查VISmax与短期 (30天) 和长期 (1年) 的全因死亡率之间的关联.
- 确定VISmax是否可以作为该患者群体中死亡率的预测指标.
主要方法:
- 追溯分析了512名接受重大腹部手术并入院于ICU的患者.
- 基于在手术后的前24小时内最大剂量的血管活性药物和内药物的VISmax计算.
- 将VISmax分为五个类别的分层,使用考克斯的比例危险模型和ROC分析.
主要成果:
- 与VISmax最高 (>45) 的患者相比,与VISmax最低 (≤5) 的患者相比,30天死亡率 (HR 3.73) 和1年死亡率 (HR 2.76) 的风险显著增加.
- 接收器操作特征 (ROC) 分析表明VISmax的预测能力中等,AUC值为30天死亡率0.69和1年死亡率0.67.
结论:
- 术后早期 (前24小时) 的VISmax升高是增加短期和长期死亡率的重要预测因素.
- 在重大腹部手术后,VISmax可能是风险分层和识别高风险患者的宝贵工具.
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