综合增剂混合模型来评估患者的呼吸比率和死亡率之间的关联:一项回顾性队列研究
Hongjie Yu1, Jie Gu2, Dang Lin2
1Department of Thoracic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China.
在重症患者中,更高的呼吸器比率 (VR) 预测死亡率. 随着时间的推移,VR的动态变化进一步表明了预后,VR的增加与较高的死亡率有关,有助于风险分层.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 预测生物标志物 预测生物标志物
背景情况:
- 以前的研究将更高的呼吸器比率 (VR) 与死亡率的增加联系起来.
- 随着时间的推移,VR中的动态变化对重症患者的预后的影响仍然不清楚.
研究的目的:
- 在重症患者中调查呼吸器比率 (VR) 动态的预后意义.
- 确定VR趋势的演变是否预测了重症监护室 (ICU) 设置中的死亡率.
主要方法:
- 使用密集护理III (MIMIC-III) 数据库的医疗信息中心来获取患者数据.
- 使用多变量考克斯回归来评估VR与30天和90天死亡率的关联.
- 应用了通用添加混合模型来比较幸存者和非幸存者之间的VR趋势.
主要成果:
- 基线VR≥1.89是30天 (HR:2.10) 和90天死亡率 (HR:2.18) 的独立预测因素.
- 亚组分析显示VR与30天死亡率之间存在一致的关联.
- 幸存者和非幸存者之间的VR差异每天增加0.01,这表明随着时间的推移,预后会恶化.
结论:
- 呼吸器比率 (VR) 动态反映了重症患者的病理生理变化.
- 越来越多的VR趋势与死亡率的增加有关.
- 监测动态的VR转变可以为风险分层和干预提供及时的预后信息.
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