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严重创伤患者低血清硒水平对临床预后的影响:系统评价和荟萃分析。

The Impact on the Clinical Prognosis of Low Serum Selenium Level in Patients with Severe Trauma: Systematic Review and Meta-Analysis.

机构信息

Division of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 33328, Taiwan.

Department of Electrical Engineering, Chang Gung University, Taoyuan 33328, Taiwan.

出版信息

Nutrients. 2022 Mar 18;14(6):1295. doi: 10.3390/nu14061295.

Abstract

This study was designed to examine the most up-to-date evidence about how low plasma selenium (Se) concentration affects clinical outcomes, such as mortality, infectious complications, and length of ICU or hospital stay, in patients with major trauma. We searched three databases (MEDLINE, EMBASE, and Web of Science) with the following keywords: "injury", "trauma", "selenium", and "trace element". Only records written in English published between 1990 and 2021 were included for analysis. Four studies were eligible for meta-analyses. The results of the meta-analysis showed that a low serum selenium level did not exert a negative effect on the mortality rate (OR 1.07, 95% CI: 0.32, 3.61, = 0.91, heterogeneity, I = 44%). Regarding the incidence of infectious complications, there was no statistically significant deficit after analyses of the four studies (OR 1.61, 95% CI: 0.64, 4.07, = 0.31, heterogeneity, I = 70%). There were no differences in the days spent in the ICU (difference in means (MD) 1.53, 95% CI: -2.15, 5.22, = 0.41, heterogeneity, I = 67%) or the hospital length of stay (MD 6.49, 95% CI: -4.05, 17.02, = 0.23, heterogeneity, I = 58%) in patients with low serum Se concentration. A low serum selenium level after trauma is not uncommon. However, it does not negatively affect mortality and infection rate. It also does not increase the overall length of ICU and hospital stays.

摘要

这项研究旨在检查最新证据,了解低血浆硒(Se)浓度如何影响主要创伤患者的临床结局,如死亡率、感染并发症以及 ICU 或住院时间。我们使用以下关键字在三个数据库(MEDLINE、EMBASE 和 Web of Science)中进行了搜索:“injury”、“trauma”、“selenium”和“trace element”。仅分析了 1990 年至 2021 年间以英文发表的记录。四项研究符合荟萃分析的条件。荟萃分析的结果表明,低血清硒水平对死亡率没有负面影响(OR 1.07,95%CI:0.32,3.61, = 0.91,异质性,I = 44%)。关于感染并发症的发生率,四项研究的分析结果并无统计学差异(OR 1.61,95%CI:0.64,4.07, = 0.31,异质性,I = 70%)。在 ICU 住院天数(均值差值(MD)1.53,95%CI:-2.15,5.22, = 0.41,异质性,I = 67%)或住院时间(MD 6.49,95%CI:-4.05,17.02, = 0.23,异质性,I = 58%)方面,低血清 Se 浓度的患者之间没有差异。创伤后低血清硒水平并不少见。然而,它不会对死亡率和感染率产生负面影响。它也不会增加 ICU 和住院总时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aed8/8952795/f63326f080a0/nutrients-14-01295-g001.jpg

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