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在创伤患者中,术前RDW和术后肺栓塞之间的关联:倾向性得分匹配的多中心队列研究
Xiaojuan Xiong1, Mi Zhou1, Peng Hu2
1Department of Anesthesiology, Daping Hospital, Army Medical University, Chongqing, People's Republic of China.
概括
在手术前红细胞分布宽度 (RDW) 升高预示着创伤患者肺栓塞 (PE) 的风险更高. 14.4%或更高的RDW显著增加了这种术后风险.
科学领域:
- 医学研究 医学研究
- 临床诊断 临床诊断 临床诊断
- 创伤外科手术是什么
背景情况:
- 红细胞分布宽度 (RDW) 与静脉血栓栓塞有关.
- 在外科创伤患者中,RDW对术后肺栓塞 (PE) 的预测价值尚未得到充分证实.
研究的目的:
- 调查手术前RDW与外科创伤患者手术后PE风险之间的相关性.
- 确定高RDW作为该人群中PE的独立风险因素.
主要方法:
- 分析了来自多个机构的46,506名外科创伤患者和MIMIC-IV 2.2数据库.
- 使用接收机运行特征曲线 (ROC) 和逻辑回归 (单变量和多变量).
- 倾向性得分匹配 (PSM) 在10235对匹配对的26个共变量上进行.
主要成果:
- 手术后PE发生率为0.56%.
- 手术前的RDW显示PE具有显著的预测价值 (AUC为0.723).
- 升高的RDW (≥14.4%) 独立地与增加的PE风险有关,无论是在 (OR 4.70) 之前还是在PSM (OR 1.67) 之后.
结论:
- 在创伤患者中,手术前提升的RDW是术后PE的独立风险因素.
- 一个RDW值≥14.4%表明PE的风险显著增加.
- 在手术创伤中,RDW可以作为PE风险分层的有价值的手术前标记.
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