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危重症患者第一周贫血与长期死亡率相关:基于倾向评分的分析。

Anaemia in the first week may be associated with long-term mortality among critically ill patients: propensity score-based analyses.

机构信息

Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.

Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

BMC Emerg Med. 2023 Mar 22;23(1):32. doi: 10.1186/s12873-023-00806-w.

Abstract

BACKGROUND

Anaemia is highly prevalent in critically ill patients; however, the long-term effect on mortality remains unclear.

METHODS

We retrospectively included patients admitted to the medical intensive care units (ICUs) during 2015-2020 at the Taichung Veterans General Hospital. The primary outcome of interest was one-year mortality, and hazard ratios (HRs) with 95% confidence intervals (CIs) were determined to assess the association. We used propensity score matching (PSM) and propensity score matching methods, including inverse probability of treatment weighting (IPTW) as well as covariate balancing propensity score (CBPS), in the present study.

RESULTS

A total of 7,089 patients were eligible for analyses, and 45.0% (3,189/7,089) of them had anaemia, defined by mean levels of haemoglobin being less than 10 g/dL. The standardised difference of covariates in this study were lower than 0.20 after matching and weighting. The application of CBPS further reduced the imbalance among covariates. We demonstrated a similar association, and adjusted HRs in original, PSM, IPTW and CBPS populations were 1.345 (95% CI 1.227-1.474), 1.265 (95% CI 1.145-1.397), 1.276 (95% CI 1.142-1.427) and 1.260 (95% CI 1.125-1.411), respectively.

CONCLUSIONS

We used propensity score-based analyses to identify that anaemia within the first week was associated with increased one-year mortality in critically ill patients.

摘要

背景

贫血在危重症患者中非常普遍;然而,其对死亡率的长期影响尚不清楚。

方法

我们回顾性纳入了 2015 年至 2020 年期间在台中荣民总医院内科重症监护病房(ICU)住院的患者。主要观察终点为 1 年死亡率,并确定危险比(HR)及其 95%置信区间(CI)以评估相关性。本研究采用倾向评分匹配(PSM)和倾向评分匹配方法,包括逆概率治疗加权(IPTW)和协变量平衡倾向评分(CBPS)。

结果

共有 7089 例患者符合分析条件,其中 45.0%(3189/7089)的患者患有贫血,定义为平均血红蛋白水平低于 10 g/dL。匹配和加权后,本研究中协变量的标准化差异小于 0.20。应用 CBPS 进一步减少了协变量之间的不平衡。我们得出了相似的相关性,原始、PSM、IPTW 和 CBPS 人群的校正 HR 分别为 1.345(95%CI 1.227-1.474)、1.265(95%CI 1.145-1.397)、1.276(95%CI 1.142-1.427)和 1.260(95%CI 1.125-1.411)。

结论

我们使用基于倾向评分的分析方法发现,危重症患者入院后第一周内出现贫血与 1 年死亡率增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14a3/10035173/ec8a8f5d6cf8/12873_2023_806_Fig1_HTML.jpg

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