Yang Guifang, Zhou Yang, He Huaping, Pan Xiaogao, Chai Xiangping
Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China.
Front Physiol. 2019 Sep 27;10:1253. doi: 10.3389/fphys.2019.01253. eCollection 2019.
This work explored the prognostic prediction capabilities of ischemia-modified albumin (IMA) in patients suffering from acute aortic dissection (AAD).
We conducted a retrospective analysis using electronic health records. This study included AAD patients admitted to the Second Xiangya Hospital of Central South University from January 2015 to December 2018 in ≤24 h from the onset of symptoms to hospital admission. The levels of IMA were recorded upon admittance and the final was the all-cause mortality during hospitalization.
This study enrolled 731 AAD patients. Among who, 160 passed away in the course of medication while 571 of them survived. Those who passed away exhibited higher levels of IMA (94.35 ± 26.84 vs. 69.14 ± 14.70, < 0.001) than the survivors. Following the adjustment confounders, the fully adjusted model showed IMA to be an independent forecastor for in-hospital mortality for AAD patients (OR 1.10, 95% CI 1.08-1.13, < 0.001). Analysis based on receiver operating characteristic (ROC) revealed that 79.35 μ/ml was the best threshold of IMA level. The area under the curve (AUC) based on this IMA level was 0.854 (95% CI 0.822-0.898) while the specificity and sensitivity to anticipate in-hospital death were 84.8 and 80.6%, respectively.
Admission IMA was an independent forecastor for in-hospital mortality among people suffering from AAD.
本研究探讨了缺血修饰白蛋白（IMA）对急性主动脉夹层（AAD）患者的预后预测能力。
我们使用电子健康记录进行了一项回顾性分析。本研究纳入了2015年1月至2018年12月期间在中南大学湘雅二医院就诊的AAD患者，这些患者从症状发作到入院的时间≤24小时。入院时记录IMA水平，终点为住院期间的全因死亡率。
本研究共纳入731例AAD患者。其中，160例在治疗过程中死亡，571例存活。死亡患者的IMA水平（94.35±26.84 vs. 69.14±14.70，<0.001）高于存活患者。在调整混杂因素后，完全调整模型显示IMA是AAD患者住院死亡率的独立预测因素（OR 1.10，95%CI 1.08-1.13，<0.001）。基于受试者工作特征（ROC）分析显示，79.35μ/ml是IMA水平的最佳阈值。基于该IMA水平的曲线下面积（AUC）为0.854（95%CI 0.822-0.898），预测住院死亡的特异性和敏感性分别为84.8%和80.6%。
入院时的IMA是AAD患者住院死亡率的独立预测因素。
