首页|红细胞分布宽度/白蛋白比值与老年脓毒症患者1年内死亡风险的关系

红细胞分布宽度/白蛋白比值与老年脓毒症患者1年内死亡风险的关系

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  • 万方数据
  • 维普
目的 探讨红细胞分布宽度/白蛋白比值(red cell distribution width/albumin ratio,RAR)与老年脓毒症患者1年内死亡风险的关系.方法 本研究为回顾性研究,数据来自美国重症监护医学信息数据库Ⅳ(MIMICⅣ2.2).主要结局是老年脓毒症患者1年内出现的死亡事件.首先采用Boruta算法确定RAR的重要性.进而,构建多因素Cox回归模型,并以限制立方样条回归曲线评估RAR与老年脓毒症患者1年内死亡事件的关联.采用Kaplan-Meier生存分析,对出现终点事件差异进行估计.最后用亚组分析来评估结果的稳健性.结果 共纳入3 018例年龄≥65岁的脓毒症患者,1年内病死率为60.8％.多因素Cox回归分析显示,RAR与老年脓毒症患者1年内死亡风险相关(HR=1.206,P＜0.0001).进一步运用Kaplan-Meier生存曲线进行分析,结果显示,高RAR水平组较低RAR水平组的患者在1年内的病死率显著增高.借助限制立方样条回归模型,显示老年脓毒症患者1年内死亡风险随RAR升高而呈现线性增长.亚组分析表明,急性呼吸衰竭和RAR与1年内死亡事件风险之间存在交互作用(P=0.0477).Boruta算法表明,RAR是老年脓毒症患者不良结局的重要特征.结论 高水平的RAR与老年脓毒症患者1年内死亡风险显著相关,RAR对老年脓毒症患者1年内死亡风险具有良好的预测价值.
The relationship between red cell distribution width/albumin ratio and one-year mortality risk in elderly patients with sepsis
Objective To investigate the association between red cell distribution width/albumin ratio(RAR)and one-year mortality risk in elderly patients with sepsis.Methods This study was a retrospective observational cohort study by using the data from the Medical Information Mart for Intensive Care(MIMIC)Ⅳ2.2.The primary outcome was death within one year.Firstly,the importance of RAR was determined by the Boruta algorithm.Multivariate Cox regression analysis and restricted cubic spline regression curve were used to assess the association of RAR with mortality within one year in elderly patients with sepsis.Kaplan-Meier survival analysis was used to estimate the differences in endpoint events.Finally,we further verified the robustness and reliability of the study results through detailed subgroup analysis.Results The study included 3 018 participants aged 65 years or older.The one-year mortality was 60.8％.Multivariate Cox regression showed that RAR was independently associated with one-year mortality risk in elderly patients with sepsis(HR=1.206,P＜0.0001).According to Kaplan-Meier survival curve analysis,the one-year mortality in the high RAR group was significantly higher than that in the low RAR group.The restricted cubic spline regression model showed that the one-year mortality in the elderly patients with sepsis increased linearly with the increase of RAR.Finally,subgroup analysis showed an interaction of acute respiratory failure and RAR with one-year mortality risk(P=0.0477).In addition,the Boruta algorithm indicated that RAR was an important feature of adverse outcomes in elderly patients with sepsis.Conclusions High levels of RAR are associated with an increased risk of death within one year in elderly patients with sepsis,and RAR has good predictive value for the one-year mortality risk in elderly patients with sepsis.

Old peopleSepsisRed cell distribution width/albumin ratioOne-year mortalityCox regression modelRestricted cubic spline regression curveKaplan-Meier survival analysisInteraction

吕子文、谷君辉、高卓、刘东

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075031 河北张家口,河北北方学院研究生院

100142 北京,空军特色医学中心

老年 脓毒症 红细胞分布宽度/白蛋白比值 1年内病死率 Cox回归模型 限制立方样条回归曲线 Kaplan-Meier生存分析 交互

2025

10.3969/j.issn.1002-1949.2025.01.005

中国急救医学
中国医师协会,黑龙江省科学技术情报研究所

中国急救医学

影响因子：1.868
ISSN：1002-1949
年,卷(期)：2025.45(1)