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血小板与淋巴细胞比值作为危重症患者谵妄的预测指标:一项回顾性观察研究。

Platelet-to-lymphocyte ratio as a predictive index for delirium in critically ill patients: A retrospective observational study.

作者信息

Jiang Xuandong, Shen Yanfei, Fang Qiang, Zhang Weimin, Cheng Xuping

机构信息

Intensive Care Unit, Dongyang People's Hospital, Dongyang.

Intensive Care Unit, Zhejiang Hospital.

出版信息

Medicine (Baltimore). 2020 Oct 23;99(43):e22884. doi: 10.1097/MD.0000000000022884.

Abstract

Delirium is a neuropsychiatric syndrome commonly encountered in critically ill patients, and systemic inflammation has been strongly implicated to underlie its pathophysiology. This study aimed to investigate the predictive value of the platelet-to-lymphocyte ratio (PLR) for delirium in the intensive care unit (ICU).In this retrospective observational study, we analyzed the clinical and laboratory data of 319 ICU patients from October 2016 to December 2017. Using the Locally Weighted Scatterplot Smoothing technique, a PLR knot was detected at a value of approximately 100. Logistic regression was used to investigate the association between the PLR and delirium.Of the 319 patients included in this study, 29 (9.1%) were diagnosed with delirium. In the delirium group, the duration of mechanical ventilation was significantly longer than that in the no-delirium group (40.2 ± 65.5 vs. 19.9 ± 26.5 hours, respectively; P < .001). A multiple logistic regression analysis showed that PLR > 100 (odds ratio [OR]: 1.003, 95% confidence interval [CI]: 1.001-1.005), age (OR: 2.76, 95% CI: 1.110-6.861), and the ratio of arterial oxygen partial pressure to the inspired oxygen fraction (OR: 0.996, 95% CI: 0.992-0.999) were independent predictors of delirium.In our study, a high PLR value on ICU admission was associated with a higher incidence of delirium. Owing to easy calculability, the PLR could be a useful delirium predictive index in ICUs, thereby enabling early interventions to be implemented.

摘要

谵妄是危重症患者中常见的一种神经精神综合征,全身炎症被认为是其病理生理学的重要基础。本研究旨在探讨血小板与淋巴细胞比值(PLR)对重症监护病房(ICU)患者谵妄的预测价值。在这项回顾性观察研究中,我们分析了2016年10月至2017年12月期间319例ICU患者的临床和实验室数据。使用局部加权散点图平滑技术,检测到PLR的一个节点值约为100。采用逻辑回归分析PLR与谵妄之间的关联。本研究纳入的319例患者中,29例(9.1%)被诊断为谵妄。谵妄组的机械通气时间明显长于非谵妄组(分别为40.2±65.5小时和19.9±26.5小时;P<0.001)。多元逻辑回归分析显示,PLR>100(比值比[OR]:1.003,95%置信区间[CI]:1.001-1.005)、年龄(OR:2.76,95%CI:1.110-6.861)和动脉血氧分压与吸入氧分数之比(OR:0.996,95%CI:0.992-0.999)是谵妄的独立预测因素。在我们的研究中,ICU入院时PLR值较高与谵妄发生率较高相关。由于易于计算,PLR可能是ICU中有用的谵妄预测指标,从而能够实施早期干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8388/7581125/3ceea6519dbf/medi-99-e22884-g002.jpg

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