术后第一天的最高乳酸盐水平与心脏病手术患者的术后狂妄症之间的关联
Ran An1, Xie Wu1, Dongyun Bie1
1Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
CNS neuroscience & therapeutics
|April 22, 2025
概括
术后第一天乳酸盐的最大水平升高与心脏手术后术后 Delirium (POD) 的发病率较高有关. 2.85 mmol/L的值表明患POD的风险显著增加.
科学领域:
- 心脏病学 心脏病学
- 密集护理医学 密集护理医学
- 神经科学是一个神经科学.
背景情况:
- 手术后妄 (POD) 是心脏手术后的一个常见并发症.
- 早期识别POD风险因素对于患者管理至关重要.
研究的目的:
- 研究术后第一天最大乳酸盐水平与心脏手术患者POD发病率之间的相关性.
- 为了确定乳酸水平的潜在切断值,表明POD风险增加.
主要方法:
- 从MIMIC-IV数据库中回顾性分析心脏手术患者数据.
- 应用倾向分数匹配 (PSM) 来比较患者组.
- 利用后勤回归,PSM和IPTW模型来评估乳酸盐和POD之间的关联.
主要成果:
- 在患有POD和没有POD的患者之间观察到术后第一天最大乳酸的显著差异 (中位数2.5与3.1毫摩尔/升,p<0.001).
- 对最大乳酸盐的确定切断值为2.85 mmol/L.
- 乳糖max≥2.85mmol/L的患者表现出明显更高的POD发病率 (19.2%对15.9%,p=0.029).
结论:
- 术后第一天的最大乳酸是心脏手术患者POD风险的重要预测因素.
- 术后第一天乳酸水平≥2.85 mmol/L与患POD的风险大幅增加有关.
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