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住院时长与特定生物标志物(白蛋白和淋巴细胞)以及合并症相关:对4000名患者的研究。

Length of hospitalization is associated with selected biomarkers (albumin and lymphocytes) and with co-morbidities: study on 4000 patients.

作者信息

Pontiroli Antonio E, Loreggian Lara, Rovati Marco P L, De Patto Elena, Folini Laura, Raveglia Federico, De Simone Matilde, Baisi Alessandro, Cioffi Ugo

机构信息

2nd Division of Medicine, Ospedale San Paolo and University of Milan, Milan, Italy.

2nd Division of Surgery, Ospedale San Paolo and University of Milan, Milan, Italy.

出版信息

Biomark Res. 2017 Mar 21;5:13. doi: 10.1186/s40364-017-0091-x. eCollection 2017.

Abstract

BACKGROUND

Low albumin levels and low lymphocyte counts are intra hospital conditions that exert a negative influence on prognosis, healing and length of hospitalization. The study aimed to analyze the correlation between low blood levels of albumin, low lymphocytes, and length of stay. The secondary aim was to identify other co-morbidities associated with prolonged hospital stay.

METHODS

Retrospective pilot study was conducted by analyzing anamnestic and biochemical data, related to 4038 patients admitted to ten wards of Hospital San Paolo (Milan), collected from July 1 2012 to December 31 2012. A statistical analysis was carried out using the Correlation method, Multivariate Analysis and Regression. Lymphocyte count and co-morbidities were evaluated in the whole cohort, albumin levels in 1437 patients.

RESULTS

In the whole sample, low albumin levels and low lymphocyte counts were directly correlated to longer hospitalizations. The stratification of the results by department and diagnosis suggests that there is a higher correlation in certain subpopulations, and albumin shows a greater correlation with length of stay than lymphocytes. Also advanced age, high platelets, type of diagnosis, male gender and emergency admission led to longer hospitalizations.

CONCLUSIONS

A routine check of albumin, lymphocytes and a spectrum of significant variables can provide precious information which can eventually lead to a shorter hospital stay. Knowledge of the general health status of a patient and the possibility to estimate his/her length of hospital stay are essential information for Clinical Governance, and for the improvement of internal services of hospitals on a large scale.

摘要

背景

低白蛋白水平和低淋巴细胞计数是医院内对预后、愈合及住院时间产生负面影响的情况。本研究旨在分析低血白蛋白水平、低淋巴细胞水平与住院时间之间的相关性。次要目的是确定与延长住院时间相关的其他合并症。

方法

通过分析2012年7月1日至2012年12月31日期间收治于圣保罗医院(米兰)十个病房的4038例患者的既往史和生化数据,进行回顾性试点研究。采用相关性方法、多变量分析和回归进行统计分析。在整个队列中评估淋巴细胞计数和合并症,在1437例患者中评估白蛋白水平。

结果

在整个样本中,低白蛋白水平和低淋巴细胞计数与更长的住院时间直接相关。按科室和诊断对结果进行分层表明,在某些亚组中相关性更高,且白蛋白与住院时间的相关性比淋巴细胞更大。此外,高龄、高血小板计数、诊断类型、男性性别和急诊入院导致住院时间更长。

结论

对白蛋白、淋巴细胞及一系列重要变量进行常规检查可提供宝贵信息,最终可能缩短住院时间。了解患者的总体健康状况以及估计其住院时间的可能性是临床管理以及大规模改善医院内部服务的重要信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd5/5359975/c2ec6e11ad89/40364_2017_91_Fig1_HTML.jpg

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