患有凝血异常的重症患者的死亡风险因素:回顾性队列研究
Qiu-Yu Guo1, Jun Peng1, Ti-Chao Shan2
1Department of Hematology, Qilu Hospital of Shandong University, Jinan, 250012, China.
Current medical science
|September 16, 2024
概括
在ICU患者的凝血异常与死亡率有关. 特定的标记物,如血-抗血复合物 (TAT) 和组织等离子体激活剂抑制剂复合物 (tPAIC),表明死亡风险较高,而其他标记物则可以预测存活率.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 临床病理学 临床病理学
背景情况:
- 凝血异常在ICU中普遍存在,并显著影响患者的死亡率.
- 了解凝血标志物的预后价值对于管理重症患者至关重要.
研究的目的:
- 调查特定凝血标记水平与ICU患者凝血异常死亡风险之间的关联.
- 在不同阶段的凝血障碍中识别死亡的独立风险因素.
主要方法:
- 从2021年1月到2022年12月,对451名患有凝血异常的ICU患者进行了回顾性分析.
- 多变量逻辑回归被用于在28天的随访期内确定死亡风险因素.
- 分析按非公开的DIC,公开的DIC和DIC前分类分层.
主要成果:
- 高血-抗血复合物 (TAT),组织等离子素激活剂抑制剂复合物 (tPAIC),延长的前血时间和血小板狭窄是独立的死亡预测因素.
- 在非开放性DIC中,年龄较大和血小板缺血增加了死亡风险,而等离子体α2-等离子体抑制剂复合物 (PIC) 预测了生存率.
- 升高的tPAIC与明显的DIC中的死亡率相关,以及在DIC前的血小板缺血.
结论:
- 凝血标志物 (TAT,tPAIC,PIC,血小板计数) 与ICU死亡率有显著的相关性.
- 保持静血平衡对于患者的治疗结果至关重要.
- 基于特定凝血谱的向疗法可以改善重症患者的存活率.
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