患有逆血压下降表型的重症患者患有妄想和死亡的风险增加
Nadim El Jamal1, Thomas G Brooks2, Antonijo Mrčela2
1Institute for Translational Medicine and Therapeutics (ITMAT), Smilow Center for Translational Research, University of Pennsylvania Perelman School of Medicine, 10-101, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. Nadim.ElJamal@pennmedicine.upenn.edu.
Scientific reports
|November 18, 2025
概括
在ICU中睡眠-觉醒周期的中断会增加妄想风险. 分析生命信号节奏,如血压下降,可以预测妄想和死亡,帮助预防性护理.
科学领域:
- 关键护理医学 关键护理医学
- 时间生物学 时间生物学
- 医疗信息学 医疗信息学
背景情况:
- 重症监护室 (ICU) 的环境会扰乱患者的昼夜节律,导致睡眠和清醒周期失调.
- 这种失调增加了妄想的风险,给医疗保健系统带来了巨大的财务负担.
- 了解ICU中特定时间的患者表型对于预测临床结果至关重要.
研究的目的:
- 调查高分辨率生理数据中的节律模式与ICU患者 Delirium 和死亡的发生率之间的关联.
- 探索临床实验室值在高危ICU患者群体24小时波动的差异,以确定潜在的机制和预后指标.
- 分析生理数据流中节律元件的缺失或存在如何与患者的结果有关.
主要方法:
- 节奏组件是从24小时的血压和心率测量中得出的,使用入比率和MIMIC IV数据库中的JTK_CYCLE统计数据.
- 后勤回归模型评估了中断的生命信号节奏与未来妄和死亡发生率之间的关联.
- 对临床实验室测量的24小时波动进行了建模,以将生物化学机制与扰乱的生命体节律和不良结果联系起来.
主要成果:
- 呈现逆血压下降的患者患狂妄症的风险增加了40% (OR: 1.38) 和死亡风险增加了13% (OR: 1.13).
- 反向浸泡者显示了24小时的生物化学概况,表明与夜间浸泡者相比,脏,代谢和静血功能中的昼夜计划发生了变化.
- 减轻和逆转心率和血压节奏与ICU患者死亡风险更高有关.
结论:
- 反向血压下降是ICU中痴呆症发展的早期指标,与多个器官系统中被破坏的生物节律有关.
- 包括心率和血压在内的生命信号节律受损与ICU患者的死亡风险增加有关.
- 将这些节律因素纳入预防性护理策略可能会改善患者的治疗结果,并减少医疗保健系统的负担.
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