基于大规模临床数据库 MIMIC-IV 的回顾性分析：血细胞比容与脓毒症患者 30 天死亡率的关系。

Association between hematocrit and the 30-day mortality of patients with sepsis: A retrospective analysis based on the large-scale clinical database MIMIC-IV.

机构信息

ICU, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.

Southwest Jiaotong University, Chengdu, Sichuan, China.

出版信息

PLoS One. 2022 Mar 24;17(3):e0265758. doi: 10.1371/journal.pone.0265758. eCollection 2022.

DOI:10.1371/journal.pone.0265758

PMID:35324947

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8947025/

Abstract

UNLABELLED

This research sought to ascertain the relationship between hematocrit (HCT) and mortality in patients with sepsis.

METHODS

A retrospective analysis was conducted on the clinical data of septic patients who were hospitalized between 2008 and 2019 in an advanced academic medical center in Boston, Massachusetts, registered in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, We analyzed basic information including gender, age, race, and types of the first admission, laboratory indicators including HCT, platelets, white blood cells, albumin, bilirubin, hemoglobin, and serum creatinine, and 30-day mortality. A Cox proportional hazards regression model was utilized to analyze the relationship between HCT and 30-day mortality in patients with sepsis.

RESULTS

This research recruited 2057 patients who met the research requirements from 2008 to 2019. According to the HCT level, it was classified into the low HCT level, the regular HCT level, and the high HCT level. The 30-day mortality rate was 62.6%, 27.5%, and 9.9% for patients with the low HCT level, the regular HCT level, and the high HCT level, respectively (p < 0.05). The multivariate Cox proportional hazard regression model analysis displayed that compared with patients with the regular HCT level, the 30-day mortality of patients with the low HCT level increased by 58.9% (hazard ratio = 1.589, 95% confidence interval (CI) = 1.009-2.979, p < 0.05).

CONCLUSION

The low HCT level is an independent risk factor for the increase of the 30-day mortality in patients with sepsis and can be used as a significant predictor of the clinical outcome of sepsis.

摘要

目的

本研究旨在确定血细胞比容（HCT）与脓毒症患者死亡率之间的关系。

方法

对 2008 年至 2019 年期间在马萨诸塞州波士顿一家先进学术医疗中心住院的脓毒症患者的临床数据进行回顾性分析，这些数据登记在医疗信息集市用于重症监护 IV（MIMIC-IV）数据库中。我们分析了基本信息，包括性别、年龄、种族和首次入院类型，以及实验室指标，包括 HCT、血小板、白细胞、白蛋白、胆红素、血红蛋白和血清肌酐，以及 30 天死亡率。利用 Cox 比例风险回归模型分析了 HCT 与脓毒症患者 30 天死亡率之间的关系。

结果

本研究共纳入了 2057 名符合研究要求的患者，他们来自 2008 年至 2019 年。根据 HCT 水平，将其分为低 HCT 水平、正常 HCT 水平和高 HCT 水平。低 HCT 水平、正常 HCT 水平和高 HCT 水平患者的 30 天死亡率分别为 62.6%、27.5%和 9.9%（p<0.05）。多变量 Cox 比例风险回归模型分析显示，与正常 HCT 水平患者相比，低 HCT 水平患者的 30 天死亡率增加了 58.9%（风险比=1.589，95%置信区间[CI]为 1.009-2.979，p<0.05）。