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血尿酸水平和多国支持癌症治疗协作组危险评分对发热性中性粒细胞减少症死亡率的影响。

Effect of serum uric acid level and Multinational Association for Supportive Care in Cancer risk score on febrile neutropenia mortality.

机构信息

Department of Medical Oncology, Gazi University, Ankara, Turkey.

Department of Internal Medicine, Gazi University, Ankara, Turkey.

出版信息

Support Care Cancer. 2021 Feb;29(2):1047-1053. doi: 10.1007/s00520-020-05587-7. Epub 2020 Jun 25.

Abstract

PURPOSE

The study was aimed to evaluate the effect of uric acid (UA) on the 30-day mortality of patients admitted to the tertiary referral hospital with a complaint of febrile neutropenia (FEN). The secondary aim was to evaluate the use of combining serum UA levels with the Multinational Association for Supportive Care in Cancer (MASCC) risk score.

METHODS

A retrospective study in which the MASCC score and serum UA levels were used to evaluate the mortality risk within 30 days among patients with FEN.

RESULTS

A total of 118 FEN episodes were included in the study and 17 (14%) of these patients died. While this rate is 23% in the high-risk group according to the MASCC score, it is 7% in the low-risk group (p = 0.011). In multivariate analysis of the parameters that significantly affect the 30-day FEN mortality, MASCC risk score (OR, 4.28; CI 95% 1.19-15.39, p = 0.013) and having a level of serum UA > 7 mg/dL (OR, 4.46; CI 95% 1.19-15.38, p = 0.032) was significantly increased the risk of in 30-day mortality of FEN. The rate of 30-day mortality of FEN was 0% in patients with a low MASCC risk score and UA level compared with 50% in the high MASCC risk score and high UA level group, and the difference was statistically significant (p < 0.001).

CONCLUSION

Increased level of UA at the time of FEN diagnosis was independently associated with an increased rate of 30-day mortality of FEN. The combination of the MASCC risk score and serum UA level might thoroughly predict the 30-day mortality of FEN.

摘要

目的

本研究旨在评估尿酸(UA)对因发热性中性粒细胞减少症(FEN)就诊于三级转诊医院的患者 30 天死亡率的影响。次要目的是评估联合使用血清 UA 水平和多国癌症支持治疗协会(MASCC)风险评分。

方法

本研究采用回顾性研究,使用 MASCC 评分和血清 UA 水平评估 FEN 患者 30 天内的死亡风险。

结果

共纳入 118 例 FEN 发作,其中 17 例(14%)患者死亡。虽然根据 MASCC 评分,高危组的死亡率为 23%,但低危组的死亡率为 7%(p=0.011)。在对显著影响 FEN 30 天死亡率的参数进行多变量分析时,MASCC 风险评分(OR,4.28;95%CI,1.19-15.39,p=0.013)和血清 UA 水平>7mg/dL(OR,4.46;95%CI,1.19-15.38,p=0.032)显著增加了 FEN 30 天死亡率的风险。低 MASCC 风险评分和 UA 水平的 FEN 患者 30 天死亡率为 0%,而高 MASCC 风险评分和高 UA 水平组的死亡率为 50%,差异有统计学意义(p<0.001)。

结论

FEN 诊断时 UA 水平升高与 FEN 30 天死亡率升高独立相关。MASCC 风险评分和血清 UA 水平的联合使用可能更全面地预测 FEN 的 30 天死亡率。

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