Department of Hand Microsurgical Technique Surgery, Peking University Shenzhen Hospital, Shenzhen City, Guangdong Province, China.
Baise Tiandong County People's Hospital, Tiandong County, Baise City, Guangxi Zhuang Autonomous Region Province, China.
Medicine (Baltimore). 2024 Jan 19;103(3):e36392. doi: 10.1097/MD.0000000000036392.
We aimed to determine prognostic indicators of PE patients with hemodynamic decompensation admitted to the ICU. PE patients with hemodynamic decompensation at ICU admission from Medical Information Mart for Intensive Care IV database were included. Least absolute shrinkage and selection operator with 2 specific lambdas were performed to reduce the dimension of variables after univariate analysis. Then we conducted multivariate logistic regression analysis and 2 models were built. A total of 548 patients were included, among whom 187 died. Lactate, creatine-kinase MB, troponin-T were significantly higher in death group. Eight common factors were screened out from first model statistically mostly in consistent with second model: older age, decreased hemoglobin, elevated anion gap, elevated International Standard Ratio (INR), elevated respiratory rate, decreased temperature, decreased blood oxygen saturation (SpO2) and the onset of cardiac arrest were significantly risk factors for in-Hospital mortality. The nonlinear relationships between these indicators and mortality were showed by the restricted cubic spline and cutoff values were determined. Our study demonstrated that age, hemoglobin levels, anion gap levels, INR, respiratory rate, temperature, SpO2 levels, the onset of cardiac arrest could be applied to predict mortality of PE patients with hemodynamic decompensation at ICU admission.
我们旨在确定入住 ICU 的血流动力学失代偿性 PE 患者的预后指标。纳入了来自 Medical Information Mart for Intensive Care IV 数据库的 ICU 入院时血流动力学失代偿的 PE 患者。在单变量分析后,采用两个特定的 lambda 值进行最小绝对收缩和选择算子,以降低变量的维度。然后进行多变量逻辑回归分析并建立了 2 个模型。共纳入 548 例患者,其中 187 例死亡。死亡组的乳酸、肌酸激酶-MB、肌钙蛋白-T 显著升高。从第一个模型中统计筛选出 8 个常见因素,与第二个模型基本一致:年龄较大、血红蛋白降低、阴离子间隙升高、国际标准化比值(INR)升高、呼吸频率升高、体温降低、血氧饱和度(SpO2)降低和心搏骤停的发生是住院死亡率的显著危险因素。这些指标与死亡率之间的非线性关系通过限制立方样条显示,并确定了截断值。我们的研究表明,年龄、血红蛋白水平、阴离子间隙水平、INR、呼吸频率、体温、SpO2 水平、心搏骤停的发生可用于预测 ICU 入院时血流动力学失代偿性 PE 患者的死亡率。