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心率/体温比值:脓毒症危重症患者的实用预后指标。

Heart rate/temperature ratio: A practical prognostic indicator for critically ill patients with sepsis.

作者信息

Lin Zongbin, Lin Shan

机构信息

Emergency and Critical Care Center, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.

Department of Respiratory and Critical Care Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.

出版信息

Heliyon. 2024 Jan 11;10(2):e24422. doi: 10.1016/j.heliyon.2024.e24422. eCollection 2024 Jan 30.

Abstract

BACKGROUND

We hypothesize that the heart rate/temperature ratio can predict intensive care unit (ICU) mortality in critical ill patients with sepsis. We aimed to explore the association between the heart rate/temperature ratio and ICU mortality in patients with sepsis.

METHODS

We conducted this study utilizing a comprehensive critical care medicine database. The primary endpoint assessed was ICU mortality. A multivariable logistic regression model was employed to determine the independent impact of the heart rate to temperature ratio on ICU mortality.

RESULTS

The study included 12,321 patients. A nonlinear relationship was observed between the heart rate/temperature ratio and ICU mortality, with an inflection point identified at 2.22. The results from the Multivariable logistic regression analysis revealed that the heart rate/temperature ratio independently contributed to the risk of ICU mortality. In model II, there was a 55 % higher ICU mortality rate with a heart rate/temperature ratio greater than 2.22 than with that less than 2.22 (odds ratio [OR] = 1.55, 95 % confidence interval [CI] 1.35-1.77). Moreover, an elevated heart rate/temperature ratio as a continuous variable showed a positive association with ICU mortality (OR = 2.14; 95 % CI: 1.87-2.45). The impact of the heart rate/temperature ratio on ICU mortality remained consistent across all subgroup variables. The sensitivity analysis results consistently supported the primary outcome, with an E value of 2.47. This suggests that the influence of unmeasured confounders on the observed outcomes was minimal, thereby confirming the robustness of the findings.

CONCLUSIONS

The heart rate/temperature ratio is a readily available and convenient indicator in a clinical setting. Elevated heart rate/temperature ratios, particularly those exceeding 2.22, are strongly linked to a high ICU mortality rate among critically ill sepsis patients.

摘要

背景

我们假设心率/体温比值可预测脓毒症危重症患者的重症监护病房(ICU)死亡率。我们旨在探讨脓毒症患者心率/体温比值与ICU死亡率之间的关联。

方法

我们利用一个综合重症医学数据库开展了本研究。评估的主要终点是ICU死亡率。采用多变量逻辑回归模型来确定心率与体温比值对ICU死亡率的独立影响。

结果

该研究纳入了12321例患者。观察到心率/体温比值与ICU死亡率之间存在非线性关系,确定的拐点为2.22。多变量逻辑回归分析结果显示,心率/体温比值独立导致ICU死亡风险增加。在模型II中,心率/体温比值大于2.22的患者的ICU死亡率比小于2.22的患者高55%(比值比[OR]=1.55,95%置信区间[CI]1.35-1.77)。此外,作为连续变量的升高的心率/体温比值与ICU死亡率呈正相关(OR=2.14;95%CI:1.87-2.45)。心率/体温比值对ICU死亡率的影响在所有亚组变量中均保持一致。敏感性分析结果始终支持主要结果,E值为2.47。这表明未测量的混杂因素对观察结果的影响最小,从而证实了研究结果的稳健性。

结论

心率/体温比值是临床环境中一种现成且方便的指标。升高的心率/体温比值,尤其是超过2.22的比值,与脓毒症危重症患者的高ICU死亡率密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3513/10827506/fd7555efd4f5/gr1.jpg

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