血压反应指数和性休克患者的临床结果:一个多中心队列研究
Yujie Chen1, Huizhen Jiang2, Yuna Wei3
1Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.
EBioMedicine
|July 26, 2024
概括
血压响应指数 (BPRI) 有效预测败血症患者的结果和对血管活性药物的反应. 这种简单的指标提供了与SOFA和APS等现有分数相比的或更高的预后价值.
科学领域:
- 临界护理医学 临界护理医学
- 心血管生理学心血管生理学
- 临床药理学 临床药理学
背景情况:
- 败血症是重症监护室死亡的主要原因之一.
- 血管活性药物对于治疗败血症冲击至关重要.
- 心血管对复苏的反应及其与败血症结果的联系仍然不清楚.
研究的目的:
- 评估血压响应指数 (BPRI) 作为败血症患者住院死亡率的预测指标.
- 为了比较BPRI的预后表现与已建立的风险得分.
- 使用机器学习识别影响BPRI的因素.
主要方法:
- 分析了来自三个大队伍 (北京联盟,MIMIC-IV,eICU-CRD) 的成年败血症患者.
- 血压响应指数 (BPRI) 被计算为平均动脉压除以血管活性-异位热量得分.
- 对比BPRI与SOFA和APS预测医院死亡;机器学习确定了影响因素.
主要成果:
- 与内部队列中的SOFA和APS相比,BPRI在住院死亡率方面表现出更高的预测准确性 (AUROC).
- 降低BPRI显著与增加死亡几率有关.
- 机器学习确定了呼吸支和液体平衡作为影响BPRI的关键因素.
结论:
- BPRI是一种简单,快速和精确的测量,用于测量性休克患者对血管活性药物的反应.
- BPRI作为一个有价值的预后工具,与SOFA和APS相比或优于它们.
- BPRI可以帮助临床医生识别高风险败血症患者并指导治疗决策.
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