充血性心力衰竭患者血清钠水平与全因死亡率的关系：基于Mimic-III数据库的回顾性队列研究
Relationship between serum sodium levels and all-cause mortality in congestive heart failure patients: A retrospective cohort study based on the Mimic-III database.
作者信息
Peng Shixuan, Peng Jianxing, Yang Lianju, Ke Weiqi
机构信息
Department of Oncology, Graduate Collaborative Training Base of The First People's Hospital of Xiangtan City, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Department of Orthopaedics, Anxiang People's Hospital, Changde, Hunan, China.
出版信息
Front Cardiovasc Med. 2023 Jan 13;9:1082845. doi: 10.3389/fcvm.2022.1082845. eCollection 2022.
BACKGROUND
The relationship between serum sodium levels and mortality in congestive heart failure (CHF) patients has not been well-studied previously. The non-linear correlation between serum sodium levels and mortality in patients with heart failure is currently controversial, and the relationship between different serum sodium levels and mortality is disputed. The goal of this study is to look into the relationship between serum sodium levels and all-cause mortality in people with CHF after controlling for other factors.
METHODS
The publicly accessible Mimic III database was the source of data for our study. We use the ICU Admission Scoring System to collect demographic data, laboratory findings, comorbidities, vital signs, and scoring information for each patient. Cox proportional risk analysis, smooth curve fitting, and the Kaplan-Meier survival curve were used to assess the relationship between baseline sodium levels and all-cause mortality in CHF patients.
RESULTS
The segmentation regression model discovered a turning point value of serum sodium levels (137.5 mmol/L) between serum sodium levels and all-cause mortality. According to the results of the fully adjusted Cox proportional hazard model, lower serum sodium levels (<137.5 mmol/L) were associated with an increased risk of 30, 90, 365-day, and 4-year all-cause deaths. The HRs and 95th confidence intervals were 0.96 (0.94, 0.99), 0.96 (0.94, 0.99), 0.96 (0.94, 0.98), and 0.96 (0.95, 0.98), respectively; the higher serum sodium levels (≥137.5 mmol/L) were related to an associated multiplied risk of 30, 90, 365-day, and 4-year all-cause deaths; the HRs and 95th confidence intervals were 1.02 (1.00, 1.05), 1.02 (1.00, 1.04), 1.02 (1.00, 1.03), and 1.02 (1.00, 1.03), respectively.
CONCLUSION
Serum sodium levels were u-shaped about all-cause mortality. In individuals with CHF, serum sodium levels are linked to an elevated risk of short-, medium-, and long-term all-cause mortality.
背景
此前，充血性心力衰竭（CHF）患者血清钠水平与死亡率之间的关系尚未得到充分研究。目前，心力衰竭患者血清钠水平与死亡率之间的非线性相关性存在争议，不同血清钠水平与死亡率之间的关系也存在争议。本研究的目的是在控制其他因素后，探讨CHF患者血清钠水平与全因死亡率之间的关系。
方法
我们的研究数据来源于公开可用的Mimic III数据库。我们使用ICU入院评分系统收集每位患者的人口统计学数据、实验室检查结果、合并症、生命体征和评分信息。采用Cox比例风险分析、平滑曲线拟合和Kaplan-Meier生存曲线来评估CHF患者基线钠水平与全因死亡率之间的关系。
结果
分段回归模型发现血清钠水平与全因死亡率之间存在一个血清钠水平转折点值（137.5 mmol/L）。根据完全调整后的Cox比例风险模型结果，较低的血清钠水平（<137.5 mmol/L）与30天、90天、365天和4年全因死亡风险增加相关。风险比（HRs）和95%置信区间分别为0.96（0.94，0.99）、0.96（0.94，0.99）、0.96（0.94，0.98）和0.96（0.95，0.98）；较高的血清钠水平（≥137.5 mmol/L）与30天、90天、365天和4年全因死亡风险增加相关；HRs和95%置信区间分别为1.02（1.00，1.05）、1.02（1.00，1.04）、1.02（1.00，1.03）和1.02（1.00，1.03）。
结论
血清钠水平与全因死亡率呈U形关系。在CHF患者中，血清钠水平与短期、中期和长期全因死亡风险升高有关。
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