Lopes Ana Martins, Silva Diana, Sousa Gabriela, Silva Joana, Santos Alice, Abelha Fernando José
Department of Anaesthesiology. Hospital de São João. Porto. Portugal.
Department of Anaesthesiology. Hospital de São João. Porto. Portugal; Department of Surgery. Anaesthesiology and Perioperative Medicine Unit. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.
Acta Med Port. 2017 Aug 31;30(7-8):555-560. doi: 10.20344/amp.7930.
Haematocrit has been studied as an outcome predictor. The aim of this study was to evaluate the correlation between low haematocrit at surgical intensive care unit admission and high disease scoring system score and early outcomes.
This retrospective study included 4398 patients admitted to the surgical intensive care unit between January 2006 and July 2013. Acute physiology and chronic health evaluation and simplified acute physiology score II values were calculated and all variables entered as parameters were evaluated independently. Patients were classified as haematocrit if they had a haematocrit < 30% at surgical intensive care unit admission. The correlation between admission haematocrit and outcome was evaluated by univariate analysis and linear regression.
A total of 1126 (25.6%) patients had haematocrit. These patients had higher rates of major cardiac events (4% vs 1.9%, p < 0.001), acute renal failure (11.5% vs 4.7%, p < 0.001), and mortality during surgical intensive care unit stay (3% vs 0.8%, p < 0.001) and hospital stay (12% vs 5.9%, p < 0.001).
A haematocrit level < 30% at surgical intensive care unit admission was frequent and appears to be a predictor for poorer outcome in critical surgical patients.
Patients with haematocrit had longer surgical intensive care unit and hospital stay lengths, more postoperative complications, and higher surgical intensive care unit and hospital mortality rates.
血细胞比容已作为一种预后预测指标进行研究。本研究旨在评估外科重症监护病房入院时低血细胞比容与高疾病评分系统得分及早期预后之间的相关性。
这项回顾性研究纳入了2006年1月至2013年7月期间入住外科重症监护病房的4398例患者。计算急性生理与慢性健康状况评价系统及简化急性生理学评分II值，并对所有作为参数输入的变量进行独立评估。若患者在外科重症监护病房入院时血细胞比容<30%，则将其归类为血细胞比容异常。通过单因素分析和线性回归评估入院时血细胞比容与预后的相关性。
共有1126例（25.6%）患者存在血细胞比容异常。这些患者发生主要心脏事件的比例更高（4%对1.9%，p<0.001）、急性肾衰竭的比例更高（11.5%对4.7%，p<0.001），且在外科重症监护病房住院期间的死亡率更高（3%对0.8%，p<0.001）以及住院期间的死亡率更高（12%对5.9%，p<0.001）。
外科重症监护病房入院时血细胞比容水平<30%的情况较为常见，且似乎是危重症外科患者预后较差的一个预测指标。
血细胞比容异常的患者在外科重症监护病房和医院的住院时间更长，术后并发症更多，且在外科重症监护病房和医院的死亡率更高。
