尿素氮与白蛋白比值可预测脓毒性休克患者的死亡率。
Urea to albumin ratio is a predictor of mortality in patients with septic shock.
机构信息
Department of Internal Medicine, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, Brazil.
Faculty of Nutrition, Univ Federal de Goias, UFG, Goiania, Brazil.
出版信息
Clin Nutr ESPEN. 2021 Apr;42:361-365. doi: 10.1016/j.clnesp.2021.01.007. Epub 2021 Feb 15.
BACKGROUND
The purpose of this study was to evaluate urea to albumin ratio (UAR) as predictor of mortality in patients with septic shock.
METHODS
We included all individuals aged ≥ 18 years, with the diagnosis of septic shock at Intensive Care Unit (ICU) admission. Laboratorial and clinical data was recorded within the first 24 h of the patient's admission. Serum urea and albumin concentration were used for UAR calculation. All patients were followed during their ICU stay and the mortality rate was recorded.
RESULTS
222 patients were included in the analysis; the mean age was 62.3 ± 15.1 years and 66% were male. Mortality rate during the ICU stay was 59.9% and the median UAR was 40.7 (24.5-66.1). The UAR was also higher in patients who died in the ICU and was positively correlated with APACHE II, SOFA score and CRP. The ROC ICU mortality development (AUC: 0.617; CI 95%: 0.541-0.693; p: 0.003) at the cutoff of ≥47.25. Furthermore, UAR values were associated with ICU mortality when adjusted by age, sex and APACHE II (OR: 1.011; CI95%:1.000-1.022; p = 0.043) and when adjusted by lactate (OR: 1.014; CI95%:1.003-1.024; p = 0.009).
CONCLUSIONS
Our data suggest that UAR could play a role as predictor of ICU mortality in patients with septic shock.
背景
本研究旨在评估尿素与白蛋白比值（UAR）作为预测脓毒症休克患者死亡率的指标。
方法
我们纳入了所有年龄≥18 岁、在重症监护病房（ICU）入院时被诊断为脓毒症休克的患者。在患者入院的头 24 小时内记录了实验室和临床数据。血清尿素和白蛋白浓度用于计算 UAR。所有患者在 ICU 住院期间均进行随访，并记录死亡率。
结果
共纳入 222 例患者，平均年龄为 62.3±15.1 岁，66%为男性。ICU 住院期间死亡率为 59.9%，中位数 UAR 为 40.7（24.5-66.1）。在 ICU 死亡的患者中，UAR 也较高，且与 APACHE II、SOFA 评分和 CRP 呈正相关。UAR 截断值≥47.25 时预测 ICU 死亡率的 ROC（AUC：0.617；95%CI：0.541-0.693；p=0.003）。此外，UAR 值与 ICU 死亡率相关，在调整年龄、性别和 APACHE II 后（OR：1.011；95%CI：1.000-1.022；p=0.043），在调整乳酸后（OR：1.014；95%CI：1.003-1.024；p=0.009）。
结论
我们的数据表明，UAR 可能在预测脓毒症休克患者 ICU 死亡率方面发挥作用。
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