Chen Qinchang, Huang Kai, Li Lingling, Lin Xixia, Ding Cong, Zhang Junrui, Chen Qingui
Department of Medical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China,
Division of Vascular and Thyroid Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Ther Clin Risk Manag. 2018 Aug 2;14:1347-1359. doi: 10.2147/TCRM.S170647. eCollection 2018.
We aimed to evaluate the association of serum uric acid on admission with long-term outcome of critically ill patients.
We conducted a retrospective cohort study using data extracted from the Medical Information Mart for Intensive Care III database. The primary endpoint was 90-day mortality. Propensity score matching (PSM) was performed, and multivariate Cox regression analysis was used to adjust for potential confounders. Receiver operating characteristic (ROC) curves were also used to assess the mortality predictions.
A total of 2,123 patients were included finally with a PSM cohort consisting of 556 90-day non-survivors matched 1:1 with 556 90-day survivors. No statistically significant difference of median admission uric acid was observed between the two groups (survivors 5.50 mg/dL vs non-survivors 5.60 mg/dL, =0.536). ROC area under the curve was 0.511 (95% confidence interval [CI] 0.477-0.545), suggesting that uric acid had poor discriminative powers for predicting 90-day mortality. No significant association between uric acid and 90-day mortality was found (hazard ratio 1.00, 95% CI 0.98-1.03, =0.6835).
Serum uric acid on intensive care unit admission failed to predict 90-day mortality of critically ill patients.
我们旨在评估入院时血清尿酸水平与危重症患者长期预后的相关性。
我们进行了一项回顾性队列研究，使用从重症监护医学信息数据库III中提取的数据。主要终点是90天死亡率。进行了倾向评分匹配（PSM），并使用多变量Cox回归分析来调整潜在的混杂因素。还使用受试者工作特征（ROC）曲线来评估死亡率预测。
最终纳入2123例患者，PSM队列包括556例90天非幸存者与556例90天幸存者1:1匹配。两组之间入院尿酸中位数无统计学显著差异（幸存者5.50mg/dL vs非幸存者5.60mg/dL，P=0.536）。ROC曲线下面积为0.511（95%置信区间[CI]0.477-0.545），表明尿酸对预测90天死亡率的判别能力较差。未发现尿酸与90天死亡率之间存在显著关联（风险比1.00，95%CI 0.98-1.03，P=0.6835）。
重症监护病房入院时的血清尿酸水平无法预测危重症患者的90天死亡率。
