基于 MIMIC-IV 数据库的回顾性研究：早期血清磷紊乱对脓毒症患者住院和 28 天死亡率的影响。
Effect of early serum phosphate disorder on in-hospital and 28-day mortality in sepsis patients: a retrospective study based on MIMIC-IV database.
机构信息
Departments of Critical Care Medicine, the First Affiliated Hospital of Harbin Medical University, 150001, Harbin, Heilongjiang, China.
Heilongjiang Provincial Key Laboratory of Critical Care Medicine, 23 Postal Street, Nangang District, 150001, Harbin, Heilongjiang, China.
出版信息
BMC Med Inform Decis Mak. 2024 Feb 26;24(1):59. doi: 10.1186/s12911-024-02462-x.
BACKGROUND
This study aims to assess the influence of early serum phosphate fluctuation on the short-term prognosis of sepsis patients.
METHODS
This retrospective study used the Medical Information Mart for Intensive Care IV database to analyze serum phosphate levels in sepsis patients within 3 days of ICU admission. According to the absolute value of delta serum phosphate (the maximum value minus the minimum value of serum phosphorus measured within three days), the patients were divided into four groups, 0-1.3, 1.4-2.0, 2.1-3.1, and ≥ 3.2 mg/dl. Meanwhile, the direction of delta serum phosphate was compared. With the serum phosphate change group of 0-1.3 mg/dl as the reference group, the relationship between delta serum phosphate and in-hospital mortality and 28-day mortality was analyzed by multivariate Logistics regression analysis.
RESULTS
The study involved 1375 sepsis patients. Serum phosphate changes (0-1.3, 1.4-2.0, 2.1-3.1, and ≥ 3.2 mg/dl) correlated with in-hospital and 28-day mortality variations (p = 0.005, p = 0.008). Much higher serum phosphate fluctuation elevated in-hospital and 28-day mortality. Compared to the 0-1.3 mg/dl change group, adjusted odds ratios (OR) in other groups for in-hospital mortality were 1.25 (0.86-1.81), 1.28 (0.88-1.86), and 1.63 (1.10-2.43), and for 28-day mortality were 1.21 (0.86-1.72), 1.10 (0.77-1.57), and 1.49 (1.03-2.19). Under the trend of increasing serum phosphate, the ORs of in-hospital mortality and 28-day mortality in ≥ 3.2 mg/dl group were 2.52 and 2.01, respectively.
CONCLUSION
In conclude, the delta serum phosphate ≥ 3.2 mg/dl was associated with in-hospital mortality and 28-day mortality in patients with sepsis.
背景
本研究旨在评估早期血清磷酸盐波动对脓毒症患者短期预后的影响。
方法
本回顾性研究使用医疗信息集市重症监护 IV 数据库分析了重症监护病房入院后 3 天内脓毒症患者的血清磷酸盐水平。根据血清磷酸盐的绝对差值（三天内测量的血清磷的最大值减去最小值），将患者分为四组，0-1.3、1.4-2.0、2.1-3.1 和≥3.2 mg/dl。同时，比较了血清磷酸盐变化的方向。以血清磷酸盐变化组 0-1.3 mg/dl 为参考组，采用多变量 Logistic 回归分析血清磷酸盐变化与住院死亡率和 28 天死亡率的关系。
结果
本研究共纳入 1375 例脓毒症患者。血清磷酸盐变化（0-1.3、1.4-2.0、2.1-3.1 和≥3.2 mg/dl）与住院死亡率和 28 天死亡率变化相关（p=0.005，p=0.008）。较高的血清磷酸盐波动会增加住院死亡率和 28 天死亡率。与 0-1.3 mg/dl 变化组相比，其他组住院死亡率的调整优势比（OR）分别为 1.25（0.86-1.81）、1.28（0.88-1.86）和 1.63（1.10-2.43），28 天死亡率分别为 1.21（0.86-1.72）、1.10（0.77-1.57）和 1.49（1.03-2.19）。在血清磷酸盐升高的趋势下，≥3.2 mg/dl 组住院死亡率和 28 天死亡率的 OR 分别为 2.52 和 2.01。
结论
综上所述，血清磷酸盐差值≥3.2 mg/dl 与脓毒症患者的住院死亡率和 28 天死亡率有关。
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