Association between international normalized ratio and in-hospital case fatality rate in patients with acute respiratory distress syndrome
Objective To explore relationship between international normalized ratio(INR)and in-hospital case fatality rate in patients with acute respiratory distress syndrome(ARDS)based on a large-scale clinical database in the real world.Methods In this study,ARDS patients who met 2012 Berlin definition from the Medical Information Mart for Intensive CareⅣ(MIMIC-Ⅳ)of American intensive care database were selected as research objects.According to their INR values within 24 hours of admission to the ICU,they were divided into three groups by third quartile method,namely:Q1 group(INR＜1.2),Q2 group(1.2≤INR＜1.6),and Q3 group(INR≥ 1.6).Multivariate logistic regression models and restricted cubic splines were used to evaluate correlation between INR and in-hospital case fatality rate in ARDS patients.And subgroups and interactions were further analyzed.Results A total of 760 patients were included in the study,with an average age of(60.1±17.3)years,of which 54.1％were male.The level of INR was related to the in-hospital case fatality rate of ARDS patients(P＜0.001),and the Q3 group(INR≥ 1.6)was significantly correlated with an increase in in-hospital case fatality rate(OR=2.46,95％CI 1.5-4.01,P＜0.001).After adjusting for all covariates,the effect value was still significant(OR=2.22,95％CI 1.28-3.84,P＜0.05).Restrictive cubic spline analysis found a linear relationship between INR levels and in-hospital case fatality rate in ARDS patients(P＞0.05).Subgroup analysis showed that there was no significant interaction between INR level and age,gender,ARDS severity,and whether myocardial infarction and diabetes were combined(P＞0.05).Conclusion INR level shows a linear correlation of the in-hospital case fatality rate in ARDS patients,and high INR level is associated with increased in-hospital case fatality rate.
international normalized ratio(INR)acute respiratory distress syndrome(ARDS)in-hospital case fatality rateMedical Information Mart for Intensive Care Ⅳ(MIMIC-Ⅳ)
万方数据
维普
