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SHRs,失调应激反应的生物标志物,预测败血症患者的预后:来自MIMIC-IV数据库的回顾性队列研究
Hui Lian1, Guangjian Wang2, Hongmin Zhang1
1Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
BMC infectious diseases
|April 26, 2025
概括
压力高血糖比率 (SHR) 是败血症患者死亡率的强有力的预测指标. 较高的SHRmax值表明死亡风险更高,突出其预后价值.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 败血症的研究研究.
背景情况:
- 败血症涉及到与糟糕的结果相关的失调的压力反应.
- 压力高血糖是常见的败血症表现,具有预后潜力.
- 压力高血糖比率 (SHR) 可能更好地反映了败血症的压力反应.
研究的目的:
- 为了研究SHRs与败血症患者的临床结果之间的关联.
- 评估不同SHR指标对死亡率的预测性能.
- 探索SHR在败血症的预后价值.
主要方法:
- 利用密集护理IV数据库的医疗信息市场来获取败血症患者的数据.
- 从最初的24小时ICU血糖水平计算出四个SHR指标 (SHRfirst,SHRmin,SHRmax,SHRmean).
- 使用ROC曲线分析,Kaplan-Meier生存分析和Cox回归来评估SHR的预测准确性和与死亡率的关联.
主要成果:
- 包括5025名败血症患者;656人在28天内死亡.
- 在非幸存者中,SHR显著更高.
- SHRmax显示了28天和1年死亡率的最高预测值,死亡率增加与较高的SHR值有关.
结论:
- SHR是败血症应激反应的强有力的标志物,具有显著的预后价值.
- 在预测与败血症相关的死亡率方面,SHRmax特别有效.
- SHR可以指导治疗策略的血糖管理在危急性疾病的败血症患者.
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