白蛋白血红蛋白指数：一种新的术前标志物，可预测一年内接受胃肠手术患者的死亡率和住院时间。

Albumin haemoglobin index: A novel pre-operative marker for predicting mortality and hospital stay in patients under one-year undergoing gastrointestinal surgeries.

机构信息

Department of Paediatrics, Konya Training and Application Centre, Baskent University Medical Faculty, Baskent University, Konya, Turkey.

出版信息

Afr J Paediatr Surg. 2022 Apr-Jun;19(2):89-96. doi: 10.4103/ajps.AJPS_4_21.

DOI:10.4103/ajps.AJPS_4_21

PMID:35017378

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8809471/

Abstract

AIM

The aim of this study was to evaluate the mortality and morbidity of infants <1 year of age with intestinal obstruction requiring surgical intervention and to investigate the factors affecting mortality and hospital length of stay in paediatric surgery, including albumin-haemoglobin index.

PATIENTS AND METHODS

The records of gastrointestinal paediatric surgeries in the past 10 years of patients who were <1-year-old at Baskent University Konya Hospital were obtained from the hospital and retrospectively studied. Patient characteristics, especially the relationship between albumin haemoglobin index (AHI) and hospital duration and mortality, were examined. According to the surgical areas, it also subjected this relationship to further analysed in subgroups.

RESULTS

There were 144 cases who fulfilled the inclusion criteria. Pre-operative serum AHI was analysed using receiver operating characteristics (ROC) curve analyzes. In the ROC analysis, AHI had a diagnostic value in predicting case discharge rates (area under the curve: 0.755, P = 0.001). When the cut-off point was set at 46.18, the sensitivity of the test was 57.5% and the sensitivity for predicting survival was 84%. In the logistic regression model to estimate survival, the odds ratio of AHI was 1.063 (confidence interval: 1.020-1.108, P = 0.004). In subgroup analyzes, AHI positively predicted survival in the NEC group and in the other group. In a linear regression model analysing the effect of AHI on hospital stay of length, AHI explained 10% of the variance in the hospital stay of length variable and significantly and negatively influenced the hospital length variable (β = -0.319, P = 0.05). In the linear regression model for subgroup analyzes, AHI significantly and negatively predicted hospital length of stay in the NEC and pyloric surgery groups, but positively predicted hospital length of stay in the perforation group.

CONCLUSION

The AHI can be used as a valuable marker to predict the likelihood of discharge and length of hospital stay in paediatric surgical cases <1-year-old.

摘要

目的

本研究旨在评估需要手术干预的 <1 岁婴儿肠梗阻的死亡率和发病率，并探讨影响小儿外科死亡率和住院时间的因素，包括白蛋白-血红蛋白指数。

方法

从医院获得了过去 10 年在 Baskent University Konya 医院接受胃肠道小儿外科手术的 <1 岁患者的记录，并进行了回顾性研究。检查了患者特征，特别是白蛋白-血红蛋白指数（AHI）与住院时间和死亡率之间的关系。根据手术部位，还进一步对亚组进行了这种关系的分析。

结果

符合纳入标准的有 144 例。使用接收者操作特性（ROC）曲线分析对术前血清 AHI 进行了分析。在 ROC 分析中，AHI 在预测病例出院率方面具有诊断价值（曲线下面积：0.755，P = 0.001）。当截断点设定为 46.18 时，该测试的灵敏度为 57.5%，预测生存率的灵敏度为 84%。在估计生存的逻辑回归模型中，AHI 的优势比为 1.063（置信区间：1.020-1.108，P = 0.004）。在亚组分析中，AHI 对 NEC 组和其他组的生存有积极的预测作用。在分析 AHI 对住院时间长短影响的线性回归模型中，AHI 解释了住院时间长短变量方差的 10%，并显著负向影响了住院时间长短变量（β=-0.319，P=0.05）。在亚组分析的线性回归模型中，AHI 显著负向预测 NEC 和幽门手术组的住院时间长短，但正向预测穿孔组的住院时间长短。