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基础代谢指标风险评分对死亡具有卓越的预测能力。

Superior predictive ability for death of a basic metabolic profile risk score.

作者信息

May Heidi T, Horne Benjamin D, Ronnow Brianna S, Renlund Dale G, Muhlestein Joseph B, Lappé Donald L, Pearson Robert R, Carlquist John F, Kfoury Abdallah G, Bair Tami L, Rasmusson Kismet D, Anderson Jeffrey L

机构信息

Intermountain Medical Center, Murray, UT 84157, USA.

出版信息

Am Heart J. 2009 May;157(5):946-54. doi: 10.1016/j.ahj.2008.12.021. Epub 2009 Mar 25.

Abstract

BACKGROUND

The basic metabolic profile (BMP) is a common blood test containing information about standard blood electrolytes and metabolites. Although individual variables are checked for cardiovascular health and risk, combining them into a total BMP-derived score, as to maximize BMP predictive ability, has not been previously attempted.

METHODS

Patients (N = 279,337) that received a BMP and had long-term follow-up for death were studied. Risk models were created in a training group (60% of study population, n = 167,635), validated in a test group (40% of study population, n = 111,702), and confirmed in the NHANES III (Third National Health and Nutrition Examination Survey) participants (N = 17,752). The BMP models were developed for 30-day, 1-year, and 5-year death using logistic regression with adjustment for age and sex. The BMP parameters were categorized as low, normal, or high based on the standard range of normal. Glucose was categorized as normal, intermediate, and high. Creatinine >or=2 mg/dL was further categorized as very high.

RESULTS

Average age was 53.2 +/- 20.1 years, and 44.3% were male. The areas under the curve for the training and test groups for 30-day, 1-year, and 5-year death were 0.887 and 0.882, 0.850 and 0.848, and 0.858 and 0.847, respectively. The predictive ability of these risk scores was further confirmed in the NHANES III population and independent of the Framingham Risk Score.

CONCLUSION

In large, prospectively followed populations, a highly significant predictive ability for death was found for a BMP risk model. We propose a total BMP score as an optimization of this routine baseline test to provide an important new addition to risk prediction.

摘要

背景

基本代谢指标(BMP)是一项常见的血液检测,包含有关标准血液电解质和代谢物的信息。虽然各个变量会针对心血管健康和风险进行检查,但此前尚未尝试将它们组合成一个源自BMP的总分,以最大化BMP的预测能力。

方法

对接受了BMP检测并进行长期死亡随访的患者(N = 279,337)进行了研究。在一个训练组(研究人群的60%,n = 167,635)中创建风险模型,在一个测试组(研究人群的40%,n = 111,702)中进行验证,并在国家健康和营养检查调查(NHANES)III的参与者(N = 17,752)中得到确认。使用逻辑回归并对年龄和性别进行调整,针对30天、1年和5年死亡情况建立BMP模型。根据正常标准范围,将BMP参数分为低、正常或高。血糖分为正常、中等和高。肌酐≥2mg/dL进一步分为非常高。

结果

平均年龄为53.2±20.1岁,44.3%为男性。训练组和测试组针对30天、1年和5年死亡情况的曲线下面积分别为0.887和0.882、0.850和0.848、0.858和0.847。这些风险评分的预测能力在NHANES III人群中得到进一步证实,且独立于弗雷明汉风险评分。

结论

在大规模的前瞻性随访人群中,发现BMP风险模型对死亡具有高度显著的预测能力。我们提出一个BMP总分作为对这项常规基线检测的优化,为风险预测提供一项重要的新补充。

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