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入院时血糖-钾比值可预测急性 A 型主动脉夹层患者的院内死亡率。

The blood glucose-potassium ratio at admission predicts in-hospital mortality in patients with acute type A aortic dissection.

机构信息

School of Nursing, Fujian Medical University, Fuzhou, China.

Department of Nursing, Union Hospital of Fujian Medical University, No.29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.

出版信息

Sci Rep. 2023 Sep 21;13(1):15707. doi: 10.1038/s41598-023-42827-2.

Abstract

Acute type A aortic dissection (ATAAD) is a serious cardiovascular emergency with high risk and mortality after surgery. Recent studies have shown that serum glucose-potassium ratio (GPR) is associated with the prognosis of cerebrovascular diseases. The purpose of this study was to investigate the relationship between GPR and in-hospital mortality in patients with ATAAD. From June 2019 to August 2021, we retrospectively analyzed the clinical data of 272 patients who underwent ATAAD surgery. According to the median value of GPR (1.74), the patients were divided into two groups. Univariate and multivariate logistic regression analysis were used to determine the risk factors of in-hospital mortality after ATAAD. In-hospital death was significantly more common in the high GPR group (> 1.74) (24.4% vs 13.9%; P = 0.027). The incidence of renal dysfunction in the low GPR group was significantly higher than that in the high GPR group (26.3% vs 14.8%: P = 0.019). After controlling for potential confounding variables and adjusting for multivariate logistic regression analysis, the results showed a high GPR (> 1.74) (AOR 4.70, 95% confidence interval (CI) 2.13-10.40; P =  < 0.001), lactic acid (AOR 1.14, 95% CI 1.03-1.26; P = 0.009), smokers (AOR 2.45, 95% CI 1.18-15.07; P = 0.039), mechanical ventilation (AOR 9.47, 95% CI 4.00-22.38; P =  < 0.001) was independent risk factor for in-hospital mortality in ATAAD patients, albumin (AOR 0.90, 95% CI 0.83-0.98; P = 0.014) was a protective factor for in-hospital prognosis. High GPR is a good predictor of in-hospital mortality after ATAAD surgery.

摘要

急性 A 型主动脉夹层(ATAAD)是一种严重的心血管急症,手术后风险和死亡率高。最近的研究表明,血清葡萄糖-钾比值(GPR)与脑血管疾病的预后有关。本研究旨在探讨 GPR 与 ATAAD 患者住院死亡率的关系。

从 2019 年 6 月至 2021 年 8 月,我们回顾性分析了 272 例接受 ATAAD 手术的患者的临床资料。根据 GPR 的中位数(1.74),将患者分为两组。采用单因素和多因素 logistic 回归分析确定 ATAAD 后住院死亡率的危险因素。高 GPR 组(>1.74)住院死亡明显更常见(24.4% vs. 13.9%;P=0.027)。低 GPR 组肾功能不全的发生率明显高于高 GPR 组(26.3% vs. 14.8%:P=0.019)。

在控制潜在混杂变量并进行多因素 logistic 回归分析后,结果显示高 GPR(>1.74)(AOR 4.70,95%置信区间(CI)2.13-10.40;P<0.001)、乳酸(AOR 1.14,95%CI 1.03-1.26;P=0.009)、吸烟者(AOR 2.45,95%CI 1.18-15.07;P=0.039)、机械通气(AOR 9.47,95%CI 4.00-22.38;P<0.001)是 ATAAD 患者住院死亡率的独立危险因素,白蛋白(AOR 0.90,95%CI 0.83-0.98;P=0.014)是住院预后的保护因素。高 GPR 是 ATAAD 手术后住院死亡率的良好预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03c7/10514330/12e918956fad/41598_2023_42827_Fig1_HTML.jpg

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