术前红细胞分布宽度增加和非心脏手术后功能恶化之间的关联. 一个倾向性得分和竞争风险加权的回顾性队列研究
Halldór B Olafsson1, Sigurbergur Karason1,2, Magnus K Magnusson1,3
1Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
BJA open
|March 19, 2025
概括
手术前红细胞分布宽度 (RDW) 升高与长期功能下降有关. 这项研究发现,较高的RDW水平与手术后估计的膜过率 (eGFR) 恶化相关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在外科手术期间的医学.
- 血液学 血液学 血液学
背景情况:
- 红细胞分布宽度升高 (RDW) 是已知的术后死亡率预测因素.
- 术前RDW与长期结局之间的关联仍然不太了解.
研究的目的:
- 调查术前RDW升高与术后长期功能恶化之间的关系.
- 检查急性损伤 (AKI) 的发生率与手术前的RDW水平相关.
主要方法:
- 对接受非心脏手术的成年患者进行回顾性队列研究 (2005-2018).
- 倾向性得分匹配分析将不同手术前RDW水平 (13.3-14.0%,14.0-14.7%,14.7-15.8%) 的组与对照组 (RDW ≤13.3%) 进行比较.
- 用精细灰色竞争性风险回归,将死亡作为竞争性事件,以评估主要结果 (持续的eGFR类别恶化) 和次要结果 (AKI,住院,再接收).
主要成果:
- 较高的手术前RDW (14.0-14.7%,14.7-15.8%,>15.8%) 与长期估计的淋巴细胞过率 (eGFR) 恶化的风险增加有关.
- 没有观察到急性损伤 (AKI) 发生率的显著差异.
- 在RDW水平为14.0-14.7%,14.7-15.8%和>15.8%的患者中,注意到重新入院的风险增加.
结论:
- 术前红细胞分布宽度的增加与手术后估计的球膜过率类别的长期恶化有关.
- RDW可以作为预测术后功能下降的潜在生物标志物.
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