的波动作为预测一般住院患者死亡率的一个参数
Siyu Liang1, Lize Sun2, Yuelun Zhang3
1Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Translation Medicine Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Frontiers in medicine
|July 31, 2024
概括
住院期间的水平波动与患者死亡风险增加有关. 这一措施可以作为住院患者预后不佳的有价值的预测指标.
科学领域:
- 内部医学 内部医学
- 临床化学 临床化学
- 医学统计 医学统计
背景情况:
- 缺血症是住院患者常见的电解质障碍,存在管理方面的挑战.
- 的波动,而不是绝对水平,可能是一个更关键的指标,在管理失血症.
- 了解波动的预后价值对于改善患者的治疗结果至关重要.
研究的目的:
- 调查住院期间水平波动与患者死亡率之间的关联.
- 评估一般住院患者预后不佳的波动的预测能力.
主要方法:
- 分析了北京联合医学院医院住院患者的数据.
- 用通用估计方程 (GEE) 确定波动与死亡率之间的关系.
- 用接收器运行特征 (ROC) 曲线分析来确定最佳切断值并评估预测准确性 (AUC).
主要成果:
- 在较高的波动水平和增加的死亡风险之间观察到显著的剂量依赖的关联.
- 调整后的死亡率几率 (ORs) 在波动较高的群体 (例如,ORs从5.92到157.64) 中大幅增加.
- 波动水平表现出强大的预测性能 (AUC = 0.868),最佳切线为7.5 mmol/L,达到76.5%的灵敏度和84.2%的特异性.
结论:
- 的波动水平是住院患者死亡率的重要,独立的预测指标.
- 这个参数为预测死亡率提供了可靠和准确的工具,可能简化预后评估.
相关概念视频
Disorder of Water Balance
330
Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
330
Errors occurring during blood pressure monitoring
667
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
667
Regulation of Sodium and Potassium
468
The regulation of sodium and potassium ion concentrations in the human body is a complex process governed primarily by hormones such as aldosterone, antidiuretic hormone (ADH), and atrial natriuretic peptide (ANP).
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
468
Guidelines For Measuring Vital Signs
1.6K
Following these guidelines can help nurses accurately measure vital signs, assess changes in patient conditions, and provide timely treatment when necessary. Adhering closely to the guidelines ensures the accuracy and reliability of the results.
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
Before taking a patient's vital signs, a nurse would consider and assess the patient's comfort level and ensure appropriate equipment is available.
1.6K
Regression Toward the Mean
6.3K
Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
6.3K
Introduction to Vital Signs
2.0K
Vital signs are physiological measurements that help key into the status of the body's essential functions. These include body temperature, pulse rate, respiratory rate, and blood pressure, commonly abbreviated as T, P, R, and BP. Some healthcare settings also consider oxygen saturation (SpO2) and, in specific contexts, pain and level of consciousness as additional vital signs.
Vital signs help healthcare professionals assess an individual's well-being and detect any functional changes...
Vital signs help healthcare professionals assess an individual's well-being and detect any functional changes...
2.0K


