Zhang Tong Yan, Du Ya Jun, Hou Ya Zhu, Du Qian, Dou Hai Rong, Gao Xiu Mei
Infectious Diseases Department, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
TEDA International Cardiovascular Hospital, Tianjin, China.
Heliyon. 2024 May 15;10(10):e31187. doi: 10.1016/j.heliyon.2024.e31187. eCollection 2024 May 30.
The early prediction of death is a challenge for medical staff. We evaluated the ability of the heart/breathing rate ratio (HBR) to predict mortality.
This was a single-center retrospective observational study of adult patients who had fever with or without respiratory symptoms, who survived at least 2 h after visiting the hospital, and whose lactate levels and vital signs were tested. We evaluated the distribution of mortality at different HBR levels and compared HBR with lactate.
A total of 18,872 fever clinic visits were screened, and 183 patients whose lactate levels were tested were recruited. Patients who had HBR values lower than 4·5 or higher than 5·5 had greater mortality than patients who had HBR values between 4·5 and 5·5 (21·3 % vs. 3·4 %, p = 0·003; 28·9 % vs. 3·4 %, p < 0·001, respectively). In patients whose HBR was <5, the AUROC for HBR for mortality was 0·762 (95 % CI: 0.643-0·880), and that for lactate was 0·701 (95 % CI: 0·564-0·837). In patients whose HBR was ≥5, the AUROC for HBR for mortality was 0·721 (95 % CI: 0·584-0·857), and that for lactate was 0·742 (95 % CI: 0·607-0·848).
HBR is helpful for stratifying mortality risk among critically ill patients in acute care clinics for infectious diseases.
对死亡进行早期预测对医护人员来说是一项挑战。我们评估了心率/呼吸频率比（HBR）预测死亡率的能力。
这是一项单中心回顾性观察研究，研究对象为有或无呼吸道症状的发热成年患者，这些患者在就诊后至少存活2小时，且检测了乳酸水平和生命体征。我们评估了不同HBR水平下的死亡率分布，并将HBR与乳酸进行比较。
共筛查了18872次发热门诊就诊病例，招募了183例检测了乳酸水平的患者。HBR值低于4.5或高于5.5的患者死亡率高于HBR值在4.5至5.5之间的患者（分别为21.3%对3.4%，p = 0.003；28.9%对3.4%，p < 0.001）。在HBR<5的患者中，HBR预测死亡率的受试者工作特征曲线下面积（AUROC）为0.762（95%置信区间：0.643 - 0.880），乳酸的为0.701（95%置信区间：0.564 - 0.837）。在HBR≥5的患者中，HBR预测死亡率的AUROC为0.721（95%置信区间：0.584 - 0.857），乳酸的为0.742（95%置信区间：0.607 - 0.848）。
HBR有助于在传染病急症护理诊所的重症患者中对死亡风险进行分层。
