首页|LAR对ICU腹腔感染脓毒症患者院内死亡的预测价值

LAR对ICU腹腔感染脓毒症患者院内死亡的预测价值

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目的 探讨乳酸与白蛋白比值(LAR)对重症监护室(ICU)腹腔感染脓毒症患者院内死亡率的预测价值。方法 回顾性分析2018年1月至2021年12月该院重症医学科收治的因腹腔感染引起脓毒症的175例患者临床资料,根据患者是否院内死亡分为生存组(n=94)和死亡组(n=81)。收集患者入院时一般资料及血乳酸和白蛋白水平并计算LAR,采用受试者工作特征(ROC)曲线评估LAR对于ICU脓毒症患者院内死亡率的预测价值,Cox回归分析和Kaplan-Meier曲线分析LAR与ICU死亡率之间的独立相关性。结果 两组急性生理学与慢性健康状况量表Ⅱ(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分、平均动脉压、氧合指数、降钙素原(PCT)、乳酸、白蛋白、LAR及手术患者比例比较,差异有统计学意义(P<0。05)。LAR预测ICU脓毒症休者预后的AUC为0。765(95%CI:0。695~0。835),高于APACHEⅡ评分、SOFA评分、乳酸、PCT,以LAR=1。295作为截断值,其预测的灵敏度和特异度分别为0。679、0。707。Kaplan-Meier曲线显示,高水平LAR(LAR≥1。295)的ICU死亡率高于低水平LAR(63。2%vs。41。5%),差异有统计学意义(P<0。05)。Cox回归分析结果显示,随着LAR水平升高,脓毒症死亡率呈升高趋势(P<0。05)。结论 LAR是ICU腹腔感染脓毒症患者死亡的影响因素,可有效预测患者的院内死亡风险。
Predictive value of LAR on in-hospital death of patients with intra-abdominal infection sepsis in ICU
Objective To investigate the predictive value of lactic acid to albumin ratio in the in-hospital mortality of the patients with intra-abdominal infection sepsis in ICU.Methods The clinical data in 175 pa-tients with sepsis caused by intra-abdominal infection admitted and treated in the intensive care medicine de-partment of this hospital from January 2018 to December 2021 were retrospectively analyzed.The patients were divided into the survival group (n=94) and death group (n=81) according to whether or not having in-hospital death.The general data,blood lactic acid and albumin levels of the patients at admission were collect-ed,and the LAR value was calculated.The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of LAR for the in-hospital mortality of sepsis patients in ICU.The Cox regression analysis and Kaplan-Meier curves were used to analyze the independent correlation between LAR and ICU mortality. Results There were statistically significant differences in the acute physiology and chronic health scoring sys-tem Ⅱ (APACHⅡ) score,sequential organ failure assessment (SOFA) score,mean arterial pressure,oxygen-ation index,PCT,lactic acid,albumin,LAR and the proportion of surgical patients between the two groups (P<0.05).The area under the curve (AUC) of LAR for predicting the prognosis in the patients with ICU sepsis was 0.765 (95%CI:0.695-0.835),which was higher than that of the APACHEⅡscore,SOFA score,lactic acid and PCT.With LAR=1.295 as the cutoff value,the sensitivity and specificity for its prediction were 0.679 and 0.707,respectively.The Kaplan-Meier curve showed that the ICU motality rate in high LAR (LAR≥1.29) was higher than that in low LAR,and the difference was statistically significant(63.2% vs. 41.5%,P<0.05).The Cox regression analysis results showed that the mortality in sepsis showed the increas-ing trend with the LAR level increase (P<0.05).Conclusion LAR is an influencing factor of the death in the intra-abdominal infection sepsis in ICU,which could effectively predict the risk of in-hospital death of the patients.

lactic acid to albumin ratiointensive care unitintra-abdominal infectionsepsisprognosis

金鑫、赵鸿雁、苏善道

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大庆油田总医院重症医学科,黑龙江大庆 163100

乳酸与白蛋白比值 重症监护室 腹腔感染 脓毒症 预后

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(14)