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术前肝功能检查异常与无肝脏疾病的心脏手术患者的短期和长期预后相关。

Preoperative Liver Function Test Abnormalities Were Associated With Short-Term and Long-Term Prognosis in Cardiac Surgery Patients Without Liver Disease.

作者信息

Shang Liqun, Ao Yuanhan, Lv Linhua, Lv Lihua, Zhang Yubi, Hou Jian, Yao Jianping, Wu Zhongkai

机构信息

Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.

出版信息

Front Cardiovasc Med. 2021 Nov 1;8:772430. doi: 10.3389/fcvm.2021.772430. eCollection 2021.

Abstract

To explore the value of preoperative liver function tests (LFTs) for the prognosis of cardiac surgery patients without liver disease. The Medical Information Mart for Intensive Care III (MIMIC-III) database was used to extract the clinical data. Adult cardiac patients (≥18 years) without liver disease in the database were enrolled. The association of LFTs with the time of hospital stay and ICU stay was analyzed with the Spearman correlation. Survival curves were estimated using the Kaplan-Meier method and compared by the log-rank test. Multivariable logistic regression was used to identify LFTs that were independent prognostic factors of mortality. A total of 2,565 patients were enrolled in this study. Albumin (ALB) was negatively associated with the time of hospital stay and ICU stay, while alanine transaminase (ALT), aspartate aminotransferase (AST), and total bilirubin were positively associated with the time of hospital stay and ICU stay (all < 0.001). Abnormal ALB, ALT, AST, and total bilirubin were associated with lower 90-day and 4-year survival (all < 0.001) and could be used as independent risk factors for hospital mortality and 90-day mortality. However, only ALB and total bilirubin were independent risk factors for 4-year mortality. Preoperative LFT abnormalities were associated with short-term and long-term prognosis of cardiac surgery patients without liver disease.

摘要

探讨术前肝功能检查(LFTs)对无肝脏疾病的心脏手术患者预后的价值。使用重症监护医学信息集市III(MIMIC-III)数据库提取临床数据。纳入数据库中无肝脏疾病的成年心脏患者(≥18岁)。采用Spearman相关性分析LFTs与住院时间和重症监护病房(ICU)住院时间的关联。使用Kaplan-Meier方法估计生存曲线,并通过对数秩检验进行比较。采用多变量逻辑回归确定LFTs中是死亡独立预后因素的指标。本研究共纳入2565例患者。白蛋白(ALB)与住院时间和ICU住院时间呈负相关,而丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和总胆红素与住院时间和ICU住院时间呈正相关(均P<0.001)。ALB、ALT、AST和总胆红素异常与90天和4年生存率降低相关(均P<0.001),并可作为医院死亡率和90天死亡率的独立危险因素。然而,只有ALB和总胆红素是4年死亡率的独立危险因素。术前LFT异常与无肝脏疾病的心脏手术患者的短期和长期预后相关。

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