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乳酸与白蛋白比值作为急诊科胃肠道出血预后的预测指标

Lactate to albumin ratio as a prognosis predictor in gastrointestinal bleeding in the emergency department.

作者信息

Bae Sung Jin, Namgung Myeong, Jung Kwang Yul, Lee Dong Hoon, Choi Yoon Hee, Choi Yunhyung, Chung Ho Sub

机构信息

Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, College of Medicine, Chung-Ang University, Seoul, 110, Deokan-Ro, Gwangmyeong-Si, Gyeonggi-Do, Republic of Korea.

Department of Emergency Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, 1071, Anyangcheon-Ro, Yangcheon-Gu, Seoul, Republic of Korea.

出版信息

Intern Emerg Med. 2025 Apr;20(3):877-885. doi: 10.1007/s11739-024-03723-3. Epub 2024 Jul 26.

Abstract

Gastrointestinal bleeding (GIB) is a common cause of emergency department (ED) visits, and has various prognoses. This study aimed to verify the prognostic ability of the lactate/albumin (L/A) ratio in patients with GIB compared with the AIMS65 score and blood urea nitrogen/albumin (B/A) ratio. This retrospective study included patients with GIB symptoms who visited the ED in 2019. Baseline characteristics and laboratory data were obtained to calculate the L/A and B/A ratios and AIMS65 score. Each score was evaluated as a predictor of intensive care unit (ICU) admission and in-hospital mortality by using the area under the receiver operating characteristic (AUROC) curve. The multivariate logistic regression analysis revealed that the L/A ratio significantly predicted ICU admission and in-hospital mortality. The AUROC curve for predicting ICU admission were 0.788, 0.695, and 0.586 for the L/A, B/A, and AIMS65 scores, respectively, while the AUROC curve for predicting in-hospital mortality were 0.807, 0.799, and 0.683 for the L/A, B/A, and AIMS65 scores, respectively. The L/A ratio, which consists of the serum lactate and albumin levels, showed superior performance relative to the B/A ratio and AIMS65 score in predicting the prognosis of patients with GIB.

摘要

胃肠道出血(GIB)是急诊科(ED)就诊的常见原因,且有多种预后情况。本研究旨在验证与AIMS65评分及血尿素氮/白蛋白(B/A)比值相比,乳酸/白蛋白(L/A)比值对GIB患者的预后预测能力。这项回顾性研究纳入了2019年因GIB症状前往急诊科就诊的患者。获取基线特征和实验室数据以计算L/A和B/A比值以及AIMS65评分。通过使用受试者工作特征(AUROC)曲线下面积,将每个评分作为重症监护病房(ICU)入住和院内死亡的预测指标进行评估。多因素逻辑回归分析显示,L/A比值显著预测了ICU入住和院内死亡。预测ICU入住的AUROC曲线,L/A、B/A和AIMS65评分分别为0.788、0.695和0.586,而预测院内死亡的AUROC曲线,L/A、B/A和AIMS65评分分别为0.807、0.799和0.683。由血清乳酸和白蛋白水平组成的L/A比值在预测GIB患者预后方面相对于B/A比值和AIMS65评分表现更优。

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