在心电图中ST段偏差与非心脏病重症患者30天死亡率之间的关联:回顾性单中心研究
Rafał Świstek1, Emil Dadański2, Aleksandra Kurzyca2
1Department of Interdisciplinary Intensive Care, Jagiellonian University Medical College, 30-688 Krakow, Poland.
在入院心电图 (ECG) 上的ST段偏差独立预测非心脏重症监护室 (ICU) 患者的30天死亡率. 这一发现可能会改善超出SOFA评分的风险分层.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 临床预后 临床预后
背景情况:
- 在心电图 (ECG) 上的ST段偏差 (STD) 可能表明危急病患者的心肌损伤.
- 在非心脏重症监护室 (ICU) 人群中,STD的预后意义尚未得到充分确立.
研究的目的:
- 评估ICU入院时的ST段偏差 (STD) 与30天死亡率之间的关联.
- 为了评估STD的增量预后值超出非心脏ICU患者的SOFA得分.
主要方法:
- 对307名非心脏ICU患者的回顾性研究.
- ST段偏差 (STD) 定义为在入院时≥1毫米的ST段升高或低落.
- 多变量考克斯回归和ROC曲线分析,根据SOFA得分进行调整,并进行引导验证.
主要成果:
- 在41.0%的患者中存在ST细分偏差 (STD),在未幸存者中更为频繁.
- 性病独立预测了30天死亡率 (HR=1.534,p=0.017),得到了强有力的验证.
- 将性传播疾病添加到SOFA评分中显示,模型歧视的边界显著改善 (ΔAUC=0.005,p=0.0581).
结论:
- 入院时的ST段偏差ECG是非心脏病重症患者30天死亡率的独立预测指标.
- 在这个人群中,性传播疾病可能会增加风险分层,超过SOFA得分.
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