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[新型冠状病毒肺炎危重症患者中与死亡率相关的血液学指标]

[Hematological indices associated with mortality in critically ill patients with COVID-19].

作者信息

López-García Aura Angélica, Ramos-Choreño Miguel Ángel, Sánchez-Hurtado Luis Alejandro, Romero-Gutiérrez Laura, Calleja-Alarcón Salvador, Gudiño-Turrubiates Araceli, Neri-Muñoz Natividad, Ponce-Sánchez Jesús Manuel, Colín-Martínez Tania

机构信息

Instituto Mexicano del Seguro Social, Hospital General de Zona No. 47, Unidad de Cuidados Intensivos. Ciudad de México, México.

Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Unidad de Cuidados Intensivos. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2023 Jan 2;61(1):75-81.

Abstract

BACKGROUND

The COVID-19 disease has represented one of the most important threats to health. The most severe form is acute respiratory distress syndrome (ARDS). The inflammatory response can cause hematologic changes.

OBJECTIVE

To determine the association between the Neutrophil/lymphocyte ratio (NLR) and the mean platelet volume (MPV) associated with mortality in critically ill patients with COVID-19 and ARDS.

MATERIAL AND METHODS

A retrospective study was carried out in an intensive care unit (ICU) in a public hospital, with patients in critical condition due to COVID-19 and on mechanical ventilation. The clinical characteristics of admission and severity of the disease were recorded. The end point was the ICU discharge condition.

RESULTS

162 subjects were gathered, 103 were men, with a mean age of 54.54 ± 13.53 years. 66.7% died in the ICU. The NLR had an area under the curve (aROC) of 0.62, with a cut-off point for mortality of > 7.04, sensitivity of 94.4%, specificity of 29.63%. The VPM had an aROC of 0.65 with a cut-off point > 9.5, sensitivity of 30.84%, and specificity of 92.59%; finally, the APACHE II had an aROC of 0.67 with a cut-off point > 14, sensitivity of 51.4% and specificity of 80%. The NLR presented an odds ratio (OR) of 5.02, the VPM 2.06 and the APACHE II score 1.16.

CONCLUSIONS

NLR, MPV, and APACHE II at ICU admission are associated with mortality for critically ill patients with COVID-19.

摘要

背景

新型冠状病毒肺炎(COVID-19)已成为对健康最重要的威胁之一。最严重的形式是急性呼吸窘迫综合征(ARDS)。炎症反应可导致血液学变化。

目的

确定新型冠状病毒肺炎合并ARDS的重症患者中性粒细胞/淋巴细胞比值(NLR)和平均血小板体积(MPV)与死亡率之间的关联。

材料与方法

在一家公立医院的重症监护病房(ICU)进行了一项回顾性研究,研究对象为因COVID-19病情危急且正在接受机械通气的患者。记录患者的入院临床特征和疾病严重程度。终点为ICU出院情况。

结果

共纳入162例受试者,其中男性103例,平均年龄54.54±13.53岁。66.7%的患者在ICU死亡。NLR的曲线下面积(aROC)为0.62,死亡率的截断点>7.04,敏感性为94.4%,特异性为29.63%。VPM的aROC为0.65,截断点>9.5,敏感性为30.84%,特异性为92.59%;最后,急性生理与慢性健康状况评分系统II(APACHE II)的aROC为0.67截断点>14,敏感性为51.4%,特异性为80%。NLR的比值比(OR)为5.02,VPM为2.06,APACHE II评分为1.16。

结论

ICU入院时的NLR、MPV和APACHE II与COVID-19重症患者的死亡率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0582/10395922/646c919c0237/04435117-61-1-75-g001.jpg

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