Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamada-oka, Suita, Osaka 565-0871, Japan.
Department of Medical Statistics, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-cho, Abeno-ku, Osaka city, Osaka 545-0051, Japan.
J Crit Care. 2019 Jun;51:139-144. doi: 10.1016/j.jcrc.2019.02.004. Epub 2019 Feb 4.
The aim of this study was to evaluate an association between nutritional biomarkers and prognosis in septic patients.
We retrospectively searched the association between nutritional biomarkers including serum albumin (Alb), total protein (TP), total cholesterol (T-chol), and cholinesterase (ChE), and prognosis for septic patients treated in the ICU for >7 days. We used time-dependent Cox proportional hazard regression analysis to resolve the difference of the statistical weight of each day's data for all 14 consecutive days among individual sepsis patients. The covariates were based on the minimum moving values determined from 1 day, 3 days, 7 days, and 14 days of serial data. The values of these covariates and ICU survival were considered as outcomes.
We included 136 septic patients. The decreases in the values of Alb, TP, T-chol, and ChE were significantly associated with the risk of death in the septic patients (p < .05). Especially, the daily changes of Alb were significantly associated with mortality during the ICU stay (p < .05).
We found that the changes in serial data of the nutritional markers of Alb, TP, T-chol, and ChE reflected the higher risk of death in patients with prolonged sepsis.
本研究旨在评估营养生物标志物与脓毒症患者预后之间的关系。
我们回顾性地搜索了包括血清白蛋白（Alb）、总蛋白（TP）、总胆固醇（T-chol）和胆碱酯酶（ChE）在内的营养生物标志物与 ICU 治疗>7 天的脓毒症患者预后之间的关联。我们使用时变 Cox 比例风险回归分析来解决个体脓毒症患者 14 天连续数据中每天数据的统计权重差异。协变量基于 1 天、3 天、7 天和 14 天的连续数据确定的最小移动值。将这些协变量和 ICU 生存率作为结果进行考虑。
我们纳入了 136 名脓毒症患者。Alb、TP、T-chol 和 ChE 值的降低与脓毒症患者死亡风险显著相关（p<0.05）。特别是，Alb 的每日变化与 ICU 住院期间的死亡率显著相关（p<0.05）。
我们发现 Alb、TP、T-chol 和 ChE 等营养标志物的连续数据变化反映了延长的脓毒症患者死亡风险更高。
