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血清乳酸水平可预测急诊科自发性蛛网膜下腔出血患者的死亡率。

Serum Lactate Could Predict Mortality in Patients With Spontaneous Subarachnoid Hemorrhage in the Emergency Department.

作者信息

Oh Chang Hwan, Kim Jong Won, Kim Geon Ha, Lee Kyeong Ryong, Hong Dae Young, Park Sang O, Baek Kwang Je, Kim Sin Young

机构信息

Department of Emergency Medicine, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, South Korea.

Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, South Korea.

出版信息

Front Neurol. 2020 Sep 4;11:975. doi: 10.3389/fneur.2020.00975. eCollection 2020.

Abstract

Serum lactate is a useful biomarker for prediction of mortality in critically ill patients. The purpose of this study was to identify if serum lactate could be used as a biomarker for predicting mortality in patients with subarachnoid hemorrhage (SAH) in the emergency department. This retrospective study enrolled 189 patients. Baseline demographic data and clinical characteristics of patients were obtained from medical record review. Multiple logistic regression analysis was performed to determine predictor variables significantly associated with mortality. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of variables for mortality prediction in SAH. Using multivariate logistic regression analysis, age [OR 1.05; 95% confidence interval (CI) 1.00-1.10; = 0.037], Hunt and Hess scale score (OR 3.29; 95% CI 1.62-6.70; = 0.001), serum lactate level (OR 1.33; 95% CI 1.03-1.74; = 0.032), and serum glucose level (OR 1.01; 95% CI 1.00-1.02; = 0.049) predicted overall mortality in SAH. The area under the ROC curve (AUC) value for the use of serum lactate level to predict mortality in SAH was 0.815 (95% CI 0.753-0.868) ( < 0.001). Serum lactate may be a useful biomarker for the early prediction of mortality in SAH patients in the emergency department.

摘要

血清乳酸是预测危重症患者死亡率的一种有用的生物标志物。本研究的目的是确定血清乳酸是否可作为急诊科蛛网膜下腔出血(SAH)患者死亡率的预测生物标志物。这项回顾性研究纳入了189例患者。通过病历审查获取患者的基线人口统计学数据和临床特征。进行多因素逻辑回归分析以确定与死亡率显著相关的预测变量。采用受试者工作特征(ROC)曲线分析来评估SAH患者死亡率预测变量的性能。使用多因素逻辑回归分析,年龄[比值比(OR)1.05;95%置信区间(CI)1.00 - 1.10;P = 0.037]、Hunt和Hess分级评分(OR 3.29;95% CI 1.62 - 6.70;P = 0.001)、血清乳酸水平(OR 1.33;95% CI 1.03 - 1.74;P = 0.032)和血清葡萄糖水平(OR 1.01;95% CI 1.00 - 1.02;P = 0.049)可预测SAH患者的总体死亡率。使用血清乳酸水平预测SAH患者死亡率的ROC曲线下面积(AUC)值为0.815(95% CI 0.753 - 0.868)(P < 0.001)。血清乳酸可能是急诊科SAH患者早期死亡率预测的一种有用生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba52/7499023/869e23aa2568/fneur-11-00975-g0001.jpg

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