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血清乳酸脱氢酶与心脏骤停后死亡率的关系:一项回顾性队列研究。

Relationship between serum lactate dehydrogenase and mortality after cardiac arrest: A retrospective cohort study.

机构信息

Emergency Department, Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, Zhejiang, China.

出版信息

Medicine (Baltimore). 2022 Nov 11;101(45):e31499. doi: 10.1097/MD.0000000000031499.

Abstract

Serum lactate dehydrogenase (LDH) has been identified as an independent risk factor for predicting all-cause mortality in patients with multiple diseases. However, the prognostic value of LDH levels in post-cardiac arrest patients remains uncertain. This study aimed to assess the association between LDH and mortality in intensive care unit (ICU) patients after cardiac arrest. This retrospective observational study is based on data from the Dryad Digital Repository, which included 374 consecutive adult patients after cardiac arrest. Patients were divided into 2 groups based on median LDH values. A multivariate Cox proportional hazards model was established to assess the independent relationship between LDH and ICU mortality. Cumulative mortality was compared using Kaplan-Meier curves. The cohort included 374 patients, of which 51.9% (194/374) died in the ICU. The overall death rate from cardiac arrest was significantly higher for patients with LDH ≥ 335 IU/L (59.6%) than for those with LDH < 335 IU/L (44.1%). In multiple Cox regression models, hazard ratios (HR) and corresponding 95% confidence intervals (CI) for logLDH and the 2 LDH groups were 1.72 (1.07, 2.78) and 1.42 (1.04, 1.93), respectively. Participants with LDH ≥ 335IU/L had a higher incidence of ICU mortality than LDH < 335 IU/L, as shown by the Kaplan-Meier curves (P = .0085). Subgroup analysis revealed that the association between LDH and ICU mortality was vitally stable, with all P interactions from different subgroups >.05. Serum LDH levels are positively associated with ICU mortality in patients after cardiac arrest, especially for patients with LDH ≥ 335 IU/L.

摘要

血清乳酸脱氢酶(LDH)已被确定为预测多种疾病患者全因死亡率的独立危险因素。然而,LDH 水平在心脏骤停后患者中的预后价值仍不确定。本研究旨在评估 LDH 与心脏骤停后重症监护病房(ICU)患者死亡率之间的关系。这是一项基于 Dryad 数字知识库的回顾性观察性研究,共纳入 374 例连续成年心脏骤停后患者。根据 LDH 中位数将患者分为 2 组。建立多变量 Cox 比例风险模型评估 LDH 与 ICU 死亡率之间的独立关系。使用 Kaplan-Meier 曲线比较累积死亡率。该队列包括 374 例患者,其中 51.9%(194/374)在 ICU 死亡。LDH≥335IU/L(59.6%)患者的总体心脏骤停死亡率明显高于 LDH<335IU/L(44.1%)患者。在多变量 Cox 回归模型中,logLDH 和 LDH 两组的危险比(HR)和相应的 95%置信区间(CI)分别为 1.72(1.07,2.78)和 1.42(1.04,1.93)。 Kaplan-Meier 曲线显示,LDH≥335IU/L 组 ICU 死亡率高于 LDH<335IU/L 组(P=0.0085)。亚组分析显示,LDH 与 ICU 死亡率之间的关联非常稳定,所有来自不同亚组的 P 交互值均>.05。血清 LDH 水平与心脏骤停后 ICU 死亡率呈正相关,尤其是对于 LDH≥335IU/L 的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72de/9666175/99833b9500bc/medi-101-e31499-g001.jpg

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