目的 探讨血尿素氮与白蛋白比值(blood urea nitrogen and albumin ratio,B/A)在妇科肿瘤及女性乳腺癌重症患者预后评估中的临床价值.方法 收集重症监护医学信息数据库(Medical Information Mart for Intensive Care,MIMIC)中在重症监护病房(intensive care unit,ICU)住院的妇科肿瘤和女性乳腺癌患者的一般临床资料.根据患者360d的预后情况将其分为存活组(n=472)和死亡组(n=388),比较两组患者的一般情况.根据B/A水平将患者分为低B/A组(B/A<0.075,n=435)和高B/A组(B/A≥0.075,n=425).采用Kaplan-Meier法绘制生存曲线,并建立Cox风险比例模型,比较B/A与患者360d全因死亡风险的相关性.结果 死亡组患者的B/A显著高于生存组(P<0.05).B/A与患者360d全因死亡风险整体呈非线性趋势关系(x2=18.790,P<0.001).生存分析显示,无论是总体人群还是妇科肿瘤或乳腺癌患者中,高B/A患者的累积生存率均显著低于低B/A患者(P<0.001).Cox回归分析提示B/A≥0.075是妇科肿瘤及女性乳腺癌重症患者360d全因死亡的独立危险因素(HR=1.529,95％CI:1.197～1.952,P=0.001).结论 入住ICU时高B/A是妇科肿瘤及女性乳腺癌重症患者长期死亡风险增加的独立危险因素,有助于临床医生及护理人员早期识别高危患者.
Value of blood urea nitrogen and albumin ratio in long-term prognosis of severe patients with gynecological tumors and female breast cancer
Objective To investigate the clinical value of blood urea nitrogen and albumin ratio (B/A) in prognosis assessment of severe patients with gynecological tumors and female breast cancer. Methods General clinical data were collected from the Medical Information Mart for Intensive Care (MIMIC) for gynecological tumors and female breast cancer patients admitted to intensive care unit (ICU). According to the 360 days prognosis,patients were divided into survival group (n=472) and death group (n=388),and the general situation of two groups was compared. Patients were divided into low B/A group (B/A<0.075,n=435) and high B/A group (B/A≥0.075,n=425) based on B/A levels. Kaplan-Meier method was used to plot the survival curve,and Cox risk scale model was established to compare the correlation between B/A and 360 days all-cause death risk. Results The B/A of patients in death group was significantly higher than that in survival group (P<0.05). There was a non-linear trend between B/A and 360 days all-cause death risk (x2=18.790,P<0.001). Survival analysis showed that patients with high B/A had significantly lower cumulative survival than patients with low B/A,both in the general population and in patients with gynecological tumors or female breast cancer (P<0.001). Cox regression analysis suggested that B/A≥0.075 was an independent risk factor for 360 days all-cause death in severe patients with gynecological tumors and female breast cancer (HR=1.529,95％CI:1.197-1.952,P=0.001). Conclusion High B/A at ICU admission is an independent risk factor for increased long-term mortality in severe patients with gynecological tumors and female breast cancer,and helps clinicians and caregivers identify high-risk patients early.
Blood urea nitrogen and albumin ratioGynecological tumorsBreast cancerPrognosis
万方数据
