在出血性中风患者的血糖变异性和预后之间U形关联:来自MIMIC-IV数据库的回顾性队列研究
Yuchen Liu1, Houxin Fu2, Yue Wang3
1Department of Neurosurgery, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.
Frontiers in endocrinology
|April 18, 2025
概括
高血糖变化 (GV) 增加了重症监护室 (ICU) 患有出血性中风 (HS) 的患者的死亡风险. 稳定GV可能会改善这些重症患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 神经学 神经学
- 内分泌学 在内分泌学.
背景情况:
- 高血糖变化 (GV) 在重症监护室 (ICU) 患者中很常见.
- 对于血流性中风 (HS) 患者的预后,GV的影响尚不清楚.
- 在各种患者群体中,GV与不良临床结果有关.
研究的目的:
- 为了调查GV与HS的ICU患者的短期和长期全因死亡率之间的关联.
- 使用先进的统计方法探索GV和死亡率之间的非线性关系.
- 确定与死亡风险增加相关的潜在GV值.
主要方法:
- 利用了来自MIMIC-IV 3.1数据库的数据,涉及2240名HS患者.
- 使用变化系数 (CV) 量化GV.
- 雇员考克斯比例危险回归和限制立方线 (RCS) 分析以评估死亡风险.
主要成果:
- 观察到CV与短期和长期全因死亡率之间存在U形关联 (非线性P<0.001).
- 确定了与在ICU住院期间,住院期间以及在30日,90日和180日期间死亡率增加相关的特定CV值.
- 在敏感度和子组分析中发现的结果是稳定的.
结论:
- 较高的GV与HS患者的短期和长期全因死亡率的增加显著相关.
- 这些结果表明,血糖控制和稳定可能对改善HS患者的预后至关重要.
- 对HS中GV管理策略的进一步研究是有必要的.
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