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不成熟粒细胞百分比对上消化道出血患者住院死亡率预测的有用性。

The usefulness of the percentage of immature granulocytes in predicting in-hospital mortality in patients with upper gastrointestinal bleeding.

机构信息

Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey.

Mersin University, Faculty of Medicine, Department of General Surgery, Mersin, Turkey.

出版信息

Am J Emerg Med. 2021 Aug;46:646-650. doi: 10.1016/j.ajem.2020.12.039. Epub 2020 Dec 17.

Abstract

BACKGROUND

Upper gastrointestinal bleeding (UGIB) is an important health problem with a potentially life threatening course. Measurement of immature granulocytes percentage (IG %), reflecting the fraction of circulating immature granulocyte (IG), is associated with increased mortality in patients with systemic inflammation, or distress. The aim of this study was to evaluate whether the IG% is an effective predictive marker for estimating the in-hospital mortality for patients with UGIB admitting to the emergency department (ED).

METHOD

This retrospective study included patients with UGIB who admitted to the ED, between 01.01.2019 and 31.12.2019. The patients were divided into two groups as discharged and dead. The IG% and other parameters were recorded. The primary end point of the study was in-hospital mortality. Logistic regression model was used to determine the factors affecting mortality.

RESULTS

This study included 149 patients, 94 of whom were men. The mean age of the patients was 64.5 ± 14.2. Twenty patients died during hospitalization and 129 were discharged. IG% was significantly higher in patients who died compared with patients who discharged. In the receiver operating characteristic (ROC) curves analysis to determine the in-hospital mortality, the cut-off value (>1%) for IG% level was found specificity (93.8%), sensitivity (100%), positive predictive value (PPV = 71.43%), negative predictive value (NPV = 100.00%) and area under curve (AUC = 0.98). Univariate logistic regression analysis showed that IG% was predicting in-hospital mortality (odds ratio, OR = 65.6, confidence interval, CI = 2.00-2152.6). CONCLUSıONS: High IG% levels may be used as a predictor of in-hospital mortality in patients with UGIB.

摘要

背景

上消化道出血(UGIB)是一个具有潜在生命威胁的重要健康问题。不成熟粒细胞百分比(IG%)的测量,反映了循环中不成熟粒细胞(IG)的分数,与全身炎症或痛苦患者的死亡率增加有关。本研究旨在评估 IG%是否是一种有效的预测标志物,用于估计因 UGIB 而入住急诊科(ED)的患者的住院死亡率。

方法

本回顾性研究纳入了 2019 年 1 月 1 日至 12 月 31 日期间因 UGIB 入住 ED 的患者。将患者分为出院和死亡两组。记录 IG%和其他参数。研究的主要终点是住院死亡率。使用逻辑回归模型确定影响死亡率的因素。

结果

本研究共纳入 149 例患者,其中 94 例为男性。患者的平均年龄为 64.5±14.2 岁。20 例患者在住院期间死亡,129 例患者出院。与出院患者相比,死亡患者的 IG%明显更高。在确定住院死亡率的接受者操作特征(ROC)曲线分析中,IG%水平的截断值(>1%)发现特异性(93.8%)、敏感性(100%)、阳性预测值(PPV=71.43%)、阴性预测值(NPV=100.00%)和曲线下面积(AUC=0.98)。单因素逻辑回归分析表明,IG%可预测住院死亡率(优势比,OR=65.6,置信区间,CI=2.00-2152.6)。

结论

高 IG%水平可作为 UGIB 患者住院死亡率的预测指标。

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