预测与尿道结石相关的阻塞性肌炎的感染性休克:一项回顾性研究
Kyungchan Min1, Bum Soo Kim2, Yun-Sok Ha3
1Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Korea.
Medicine
|August 2, 2024
概括
预测阻塞性急性肌炎与尿管结石的败血性休克是至关重要的. 结合 prokalcitonin,绝对淋巴细胞计数和国际正常化比率,可以有效预测败血症休克的进展.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 临界护理医学 临界护理医学
背景情况:
- 与尿道结石相关的阻塞性急性肺炎 (OAPN-US) 可以导致严重的败血症.
- 早期识别患有感染性休克风险的患者对于及时干预至关重要.
- 目前的预测模型可能无法针对这一特定患者群体进行优化.
研究的目的:
- 在OAPN-US患者中确定感染性休克预测因子的最佳组合.
- 评估所选临床和实验室标记物的预测性能.
- 适用于败血症-3标准的败血症冲击定义.
主要方法:
- 对81名接受OAPN-US. percutaneous nephrostomy的患者进行了回顾性评估.
- 应用递归特征消除 (RFE) 来识别关键预测因素.
- 使用接收器操作曲线下的面积 (AUROC) 对各种标记器组合进行预测准确度的比较.
主要成果:
- 败血性休克患者 (n=37) 比非败血性休克患者 (n=44) 年龄较大,ECOG状态较差,培养阳性较高.
- 预热素 (PCT),国际正常化比率 (INR) 和绝对淋巴细胞计数 (ALC) 被确定为RFE的显著预测因子.
- PCT,ALC和INR的组合实现了最高的AUROC (0.942),证明了出色的预测能力.
结论:
- PCT,ALC和INR的组合是OAPN-US患者感染性休克的高度有效预测剂.
- 现在,PCT已经成为最有影响力的单一预测指标.
- 这些发现可以帮助早期风险分层和管理OAPN-US.
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