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基线严重程度评分变化与危重症患者结局之间的关联通过生物阻抗分析参数的整合得到了增强。

The association between the change in severity score from baseline and the outcomes of critically ill patients was enhanced by integration of bioimpedance analysis parameters.

机构信息

National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, China.

出版信息

Sci Rep. 2024 Jun 25;14(1):14681. doi: 10.1038/s41598-024-65782-y.

Abstract

The study of the outcomes of critically ill patients has been a hard stuff in the field of intensive care. To explore the relationship between changes of severity scores, bioelectrical impedance analysis (BIA) and outcomes of critically ill patients, we enrolled patients (n = 206) admitted to intensive care unit (ICU) in Jinling Hospital from 2018 to 2021 with records of BIA on the days 1- and 3- ICU. Collected BIA and clinical data including simplified acute physiology score II (SAPS II) and sequential organ failure assessment. According to the baseline and change of severity scores or phase angle (PA) values, the patients were divided into: G-G, baseline good status, 3rd day unchanged; G-B, baseline good status, 3rd day deteriorated; B-G, baseline bad status, 3rd day improved; and B-B, baseline bad status, 3rd day unchanged. According to PA, the mortality of group G-G was 8.6%, and it was greater than 50% in group B-B for severity scores. The new score combining PA and severity scores established. Multivariate logistic regression analysis revealed that PA-SAPS II score was the only independent factor for 90-day mortality (P < 0.05). A linear correlation was found between mortality and PA-SAPS II score (prediction equation: , R = 0.96, P < 0.05).

摘要

对危重症患者结局的研究一直是重症监护领域的难题。为了探讨危重症患者严重程度评分变化、生物电阻抗分析(BIA)与结局的关系,我们纳入了 2018 年至 2021 年期间入住我院重症监护病房(ICU)且记录有 BIA 的 206 例患者。收集 BIA 和临床数据,包括简化急性生理学评分 II(SAPS II)和序贯器官衰竭评估。根据基线和严重程度评分或相位角(PA)值的变化,患者被分为:G-G,基线状态良好,第 3 天无变化;G-B,基线状态良好,第 3 天恶化;B-G,基线状态较差,第 3 天改善;B-B,基线状态较差,第 3 天无变化。根据 PA 值,G-G 组的死亡率为 8.6%,而严重程度评分组 B-B 的死亡率超过 50%。建立了联合 PA 和严重程度评分的新评分。多变量逻辑回归分析显示,PA-SAPS II 评分是 90 天死亡率的唯一独立因素(P<0.05)。死亡率与 PA-SAPS II 评分呈线性相关(预测方程: ,R=0.96,P<0.05)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57a8/11199583/4b08ab89f33a/41598_2024_65782_Fig1_HTML.jpg

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