Hu Tianyang, Qiao Zhao, Mei Ying
Department of Cardiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Health Management Center, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Front Med (Lausanne). 2021 Nov 18;8:737654. doi: 10.3389/fmed.2021.737654. eCollection 2021.
The relationship between urine output (UO) and in-hospital mortality in intensive care patients with septic shock is currently inconclusive. The baseline data, UO, and in-hospital prognosis of intensive care patients with septic shock were retrieved from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. By drawing receiver operating characteristic (ROC) curves and comparing the areas under the ROC curves (AUC) to determine the predictive value of UO for in-hospital mortality, and by drawing the Kaplan-Meier curves to compare the difference in in-hospital mortality between different groups of UO. Before and after the propensity score matching (PSM) analysis, UO was always a risk factor for in-hospital mortality in patients with septic shock. The AUC of UO was comparable to the Sequential Organ Failure Assessment (SOFA) scoring system, while the AUC of combining UO and SOFA was greater than that of SOFA. The median survival time of the high-UO group (UO > 0.39 ml/kg/h, before PSM; UO > 0.38 ml/kg/h, after PSM) was longer than that of the low-UO group. Compared with the high-UO group, the hazard ratios (HR) of the low-UO group were 2.6857 (before PSM) and 1.7879 (after PSM). UO is an independent risk factor for septic shock. Low levels of UO significantly increase the in-hospital mortality of intensive care patients with septic shock. The predictive value of UO is comparable to the SOFA scoring system, and the combined predictive value of the two surpasses SOFA alone.
在感染性休克的重症监护患者中,尿量(UO)与院内死亡率之间的关系目前尚无定论。从重症监护医学信息数据库IV(MIMIC-IV)中检索了感染性休克重症监护患者的基线数据、尿量和院内预后情况。通过绘制受试者工作特征(ROC)曲线并比较ROC曲线下面积(AUC)来确定尿量对院内死亡率的预测价值,并绘制Kaplan-Meier曲线来比较不同尿量组之间院内死亡率的差异。在倾向评分匹配(PSM)分析前后,尿量始终是感染性休克患者院内死亡的危险因素。尿量的AUC与序贯器官衰竭评估(SOFA)评分系统相当,而尿量与SOFA联合的AUC大于SOFA单独的AUC。高尿量组(PSM前尿量>0.39 ml/kg/h;PSM后尿量>0.38 ml/kg/h)的中位生存时间长于低尿量组。与高尿量组相比(PSM前),低尿量组的风险比(HR)为2.6857,(PSM后)为1.7879。尿量是感染性休克的独立危险因素。低尿量水平显著增加感染性休克重症监护患者的院内死亡率。尿量的预测价值与SOFA评分系统相当,两者的联合预测价值超过单独的SOFA。