Kaya Hakki, Kurt Recep, Beton Osman, Zorlu Ali, Yucel Hasan, Gunes Hakan, Oguz Didem, Yilmaz Mehmet Birhan
Tex Heart Inst J. 2017 Feb 1;44(1):22-28. doi: 10.14503/THIJ-15-5626. eCollection 2017 Feb.
Length of stay is the primary driver of heart-failure hospitalization costs. Because cancer antigen 125 has been associated with poor morbidity and mortality rates in heart failure, we investigated the relationship between admission cancer antigen 125 levels and lengths of stay in heart-failure patients. A total of 267 consecutive patients (184 men, 83 women) with acute decompensated heart failure were evaluated prospectively. The median length of stay was 4 days, and the patients were classified into 2 groups: those with lengths of stay ≤4 days and those with lengths of stay >4 days. Patients with longer lengths of stay had a significantly higher cancer antigen 125 level of 114 U/mL (range, 9-298 U/mL) than did those with a shorter length of stay (19 U/mL; range; 3-68) ( <0.001). The optimal cutoff level of cancer antigen 125 in the prediction of length of stay was >48 U/mL, with a specificity of 95.8% and a sensitivity of 96% (area under the curve, 0.979; 95% confidence interval [CI], 0.953-0.992). In the multivariate logistic regression model, cancer antigen 125 >48 U/mL on admission (odds ratio=4.562; 95% CI, 1.826-11.398; =0.001), sodium level (<0.001), creatinine level (=0.009), and atrial fibrillation (=0.015) were also associated with a longer length of stay after adjustment for variables found to be statistically significant in univariate analysis and correlated with cancer antigen 125 level. In addition, it appears that in a cohort of patients with acute decompensated heart failure, cancer antigen 125 is independently associated with prolonged length of stay.
住院时间是心力衰竭住院费用的主要驱动因素。由于癌抗原125与心力衰竭患者的不良发病率和死亡率相关，我们研究了心力衰竭患者入院时癌抗原125水平与住院时间之间的关系。对总共267例连续的急性失代偿性心力衰竭患者（184例男性，83例女性）进行了前瞻性评估。中位住院时间为4天，患者被分为两组：住院时间≤4天的患者和住院时间>4天的患者。住院时间较长的患者癌抗原125水平显著高于住院时间较短的患者，前者为114 U/mL（范围9 - 298 U/mL），后者为19 U/mL（范围3 - 68）（P<0.001）。预测住院时间时癌抗原125的最佳临界值为>48 U/mL，特异性为95.8%，敏感性为96%（曲线下面积为0.979；95%置信区间[CI]为0.953 - 0.992）。在多因素逻辑回归模型中，入院时癌抗原125>48 U/mL（比值比=4.562；95% CI为1.826 - 11.398；P = 0.001）、钠水平（P<0.001）、肌酐水平（P = 0.009）和心房颤动（P = 0.015）在对单因素分析中具有统计学意义且与癌抗原125水平相关的变量进行调整后，也与较长的住院时间相关。此外，在急性失代偿性心力衰竭患者队列中，癌抗原125似乎与住院时间延长独立相关。
