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系统性免疫炎症指数与充血性心力衰竭短期死亡率的关联:一项回顾性队列研究。

Association of Systemic Immune-Inflammation Index With Short-Term Mortality of Congestive Heart Failure: A Retrospective Cohort Study.

作者信息

Tang Yiyang, Zeng Xiaofang, Feng Yilu, Chen Qin, Liu Zhenghui, Luo Hui, Zha Lihuang, Yu Zaixin

机构信息

Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China.

Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Cardiovasc Med. 2021 Nov 12;8:753133. doi: 10.3389/fcvm.2021.753133. eCollection 2021.

Abstract

The present study aimed to clarify the potential predictive significance of Systemic immune-inflammation index (SII) in assessing the poor prognosis of critically ill patients with congestive heart failure (CHF). Detailed clinical data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care III database after gaining access and building the local platform. The 30- and 90-day and hospital all-cause mortalities of the patient was the primary outcome, and the readmission rate and the occurrence of major cardiovascular adverse events (MACEs) were the secondary outcomes. the Cox proportional hazard model and Logistic regression analysis were selected to reveal the relationship between SII level and the research outcome. Further, the propensity score matching (PSM) analysis was performed to improve the reliability of results by reducing the imbalance across groups. There were a total of 4,606 subjects who passed the screening process and entered the subsequent analysis. Multivariate regression analysis showed that after adjusting for possible confounders, including age, heart rate, and albumin, etc., the high level of SII was independently associated with 30- and 90-day and hospital mortalities (tertile 3 vs. tertile 1: HR, 95% CIs: 1.23, 1.04-1.45; 1.21, 1.06-1.39; 1.26, 1.05-1.50) and the incidence of MACEs (tertile 3 vs. tertile 1: OR, 95% CI: 1.39, 1.12-1.73) in critically ill patients with CHF, but no significant correlation was found between SII and the readmission rate. Consistently, patients with high SII level still presented a significantly higher short-term mortality than patients with low SII in the PSM subset. In critically ill patients with CHF, high level of SII could effectively predict high 30- and 90-day and hospital mortalities, as well as the high risk of occurrence of MACEs.

摘要

本研究旨在阐明全身免疫炎症指数(SII)在评估充血性心力衰竭(CHF)重症患者预后不良方面的潜在预测意义。在获得访问权限并建立本地平台后,从重症监护III多参数智能监测数据库中提取详细的临床数据。患者的30天、90天和住院全因死亡率是主要结局,再入院率和主要心血管不良事件(MACE)的发生率是次要结局。选择Cox比例风险模型和Logistic回归分析来揭示SII水平与研究结局之间的关系。此外,进行倾向得分匹配(PSM)分析以通过减少组间不平衡来提高结果的可靠性。共有4606名受试者通过筛选过程并进入后续分析。多变量回归分析表明,在调整包括年龄、心率和白蛋白等可能的混杂因素后,SII高水平与CHF重症患者的30天、90天和住院死亡率(三分位数3与三分位数1:HR,95%CI:1.23,1.04 - 1.45;1.21,1.06 - 1.39;1.26,1.05 - 1.50)以及MACE发生率(三分位数3与三分位数1:OR,95%CI:1.39,1.12 - 1.73)独立相关,但未发现SII与再入院率之间存在显著相关性。同样,在PSM亚组中,SII水平高的患者短期死亡率仍显著高于SII水平低的患者。在CHF重症患者中,SII高水平可有效预测30天、90天和住院高死亡率以及MACE发生的高风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b63/8632819/e6d1dd9b3adf/fcvm-08-753133-g0001.jpg

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