Department of Neurosurgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, PR China.
Department of Neurosurgery, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, Guangdong, PR China.
J Clin Neurosci. 2024 Oct;128:110777. doi: 10.1016/j.jocn.2024.110777. Epub 2024 Aug 12.
The mortality risk is exceptionally high in non-traumatic subarachnoid hemorrhage (SAH). Elevated blood urea nitrogen (BUN) levels and hypokalemia are prevalent issues in patients with non-traumatic SAH. To explore the correlation between the blood urea nitrogen-to-potassium ratio (BPR) and 30-day all-cause mortality in non-traumatic SAH patients.
We systematically extracted specific clinical data from the Medical Information Mart for Intensive IV (MIMIC-IV) database. To assess the prognostic relevance of the BPR, we categorized patients into those experiencing in-hospital mortality within 30 days and those surviving, subjecting them to both univariate and multivariate Cox regression analyses. The optimal BPR cut-off value was identified using Receiver Operating Characteristic (ROC) curve analysis, employing the maximum Youden index to predict survival status. Furthermore, we employed Kaplan-Meier (K-M) analysis to illustrate survival curves.
A cohort comprising 608 patients with non-traumatic SAH was enrolled in the investigation. Multivariate Cox regression analysis identified the BPR as an independent predictor of all-cause mortality within 30 days of admission for patients with non-traumatic SAH (Hazard Ratio [HR], 1.13; 95 % Confidence Interval [CI], 1.04---1.23; P<0.05). Further refinement resulted in the establishment of an optimized prediction model (AUC=83.61 %, 95 % CI: 79.73 % - 87.49 %) for forecasting all-cause mortality at 30 days post-hospital admission in patients with non-traumatic SAH.
The BPR emerges as an independent prognostic indicator for all-cause mortality within the initial 30 days of admission among non-traumatic SAH patients.
非创伤性蛛网膜下腔出血（SAH）患者的死亡率异常高。非创伤性 SAH 患者普遍存在血尿素氮（BUN）升高和低钾血症的问题。探讨非创伤性 SAH 患者血尿素氮与钾比值（BPR）与 30 天全因死亡率的相关性。
我们从医学信息挖掘互联网数据库（MIMIC-IV）系统地提取了特定的临床数据。为了评估 BPR 的预后相关性，我们将患者分为住院 30 天内发生院内死亡和存活的患者，对其进行单因素和多因素 Cox 回归分析。使用受试者工作特征（ROC）曲线分析确定最佳 BPR 截断值，采用最大 Youden 指数预测生存状态。此外，我们还采用 Kaplan-Meier（K-M）分析绘制生存曲线。
纳入了 608 例非创伤性 SAH 患者的队列研究。多因素 Cox 回归分析发现，BPR 是预测非创伤性 SAH 患者住院 30 天内全因死亡率的独立因素（危险比 [HR]，1.13；95%置信区间 [CI]，1.04-1.23；P<0.05）。进一步优化后建立了一个优化的预测模型（AUC=83.61%，95%CI：79.73%-87.49%），用于预测非创伤性 SAH 患者住院后 30 天全因死亡率。
BPR 是非创伤性 SAH 患者住院后 30 天内全因死亡率的独立预后指标。
