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红细胞平均体积(MCV)和红细胞分布宽度(RDW)参数作为老年患者再生潜能的潜在指标及其对急性死亡率的预测-初步报告。

Red Blood Cells Mean Corpuscular Volume (MCV) and Red Blood Distribution Width (RDW) Parameters as Potential Indicators of Regenerative Potential in Older Patients and Predictors of Acute Mortality - Preliminary Report.

机构信息

Department of Hematology, Multi-Specialist Hospital Gorzów Wielkopolski, Faculty of Medicine and Health Science, University of Zielona Góra, Gorzów Wielkopolski, Poland.

Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland.

出版信息

Stem Cell Rev Rep. 2020 Aug;16(4):711-717. doi: 10.1007/s12015-020-09977-6.

Abstract

This study presents the statistical results of patients who had been recently discharged from hospital within one month after their treatment in the emergency department (ED). Using routine (14,881) MCV and RDW measurements and statistical tools, we could predict acute mortality in these patients (N = 1158), adjusted for age. It is likely that an increase in the MCV and RDW parameters may correlate in some of our older patients with a poor prognosis with an increased level of circulating IGF-I, which affects red blood cell parameters. The research presents the prognostic statistics of the analyzed clinical factors as well as speculates on the potential correlation of these parameters with the regenerative potential of stem-cell compartment. Analysis shows that both MCV and RDW are statistically significant (Area Under Curve [AUC], lower CI 95% >50%) predictors of acute mortality in ED patients. The classification of patients based on their MCV threshold (= 92.2 units) indicates a proper clinical prognosis in nearly 6 of 10 subjects (AUC >58%), whereas taking into account RDW (=13.8%) indicates a proper clinical prognosis in no more than 7 of 10 individuals. The report concludes that by employing strongly fitting (95%) quadratic modeling of the ORs against the biomarkers studied, one can notice a similar relationship between MCV and RDW as diagnostic tools to predict regenerative potential and clinical outcomes in older patients. Although RDW alone had a 10% higher diagnostic value in terms of predicting early death in the emergency department in patients that were admitted to the ED and subsequently hospitalized, also taking the MCV measurement improved accuracy in predicting clinical outcomes by 2.5% compared to RDW alone.

摘要

这项研究呈现了在急诊科(ED)接受治疗一个月内最近出院的患者的统计结果。使用常规(14881 个)MCV 和 RDW 测量值和统计工具,我们可以预测这些患者(N=1158)的急性死亡率,同时调整年龄因素。MCV 和 RDW 参数的增加可能与我们一些年龄较大的患者的预后不良相关,这些患者的循环 IGF-I 水平升高,这会影响红细胞参数。研究提出了分析的临床因素的预后统计数据,并推测这些参数与干细胞池的再生潜力之间的潜在相关性。分析表明,MCV 和 RDW 都是 ED 患者急性死亡率的统计学上显著(曲线下面积 [AUC],95%置信区间下限>50%)预测因子。根据 MCV 阈值(=92.2 单位)对患者进行分类,近 6 名患者中有近 10 名患者(AUC>58%)有适当的临床预后,而考虑到 RDW(=13.8%),只有不到 10 名患者中有适当的临床预后。报告得出结论,通过对研究中的生物标志物进行拟合度高(95%)的 OR 二次建模,可以注意到 MCV 和 RDW 之间存在类似的关系,作为预测老年患者再生潜力和临床结果的诊断工具。虽然 RDW 单独用于预测 ED 中收治后住院的患者早期死亡的诊断价值比 MCV 高 10%,但与单独使用 RDW 相比,测量 MCV 可以将预测临床结果的准确性提高 2.5%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6689/7392927/bad0dd36be5c/12015_2020_9977_Fig1_HTML.jpg

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