在重症监护室探索急性损伤的发展轨迹:基于人口的队列研究
Ding-Yuan Wan1,2, Xin-Yao Luo3, Min He4,5,6
1West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China.
Scientific reports
|September 26, 2025
概括
使用内皮激活和压力指数 (EASIX) 轨迹分析识别不同的急性损伤 (AKI) 亚表型,揭示了两个组:"稳定高" (SH) 和"下降" (D). 与D组相比,SH组的死亡风险明显高于D组.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 临界护理医学 临界护理医学
- 生物统计学 生物统计学
背景情况:
- 急性损伤 (AKI) 是一种异质的疾病,临床结果各不相同.
- 亚表型化AKI对于标准化研究和优化治疗至关重要.
- 内皮激活和压力指数 (EASIX) 反映了AKI中血栓性微血管病变的严重程度.
研究的目的:
- 使用EASIX轨迹分析来识别不同的AKI亚型.
- 评估已识别的AKI亚表型的临床特征和预后影响.
主要方法:
- 在eICU协作研究数据库中,基于组的EASIX分数的轨迹建模在最初的七天ICU中的EASIX分数.
- 变量选择的Lasso回归和多变量考克斯回归用于危险比率计算.
- 使用来自西中国医院 (WCH) 的队列进行独立验证.
主要成果:
- 确定了两种AKI亚现象:"稳定高" (SH) 和"下降" (D) EASIX轨迹.
- 与D组相比,SH组的ICU死亡率 (HR 2.26) 和30天住院死亡率 (HR 1.85) 显著更高.
- 结果在WCH队列中得到了验证,证实了临床因素和结果的显著异质性.
结论:
- 通过EASIX轨迹分析,有效地确定了两种不同的AKI亚型,具有不同的死亡风险.
- 这些子类型在临床表现,并发症和结果方面表现出显著的异质性.
- 进一步的研究应侧重于早期预测,向治疗,以及了解AKI亚表型变异的分子基础.
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