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血清渗透压与脑出血患者院内死亡风险的关联

Association between serum osmolality and risk of in-hospital mortality in patients with intracerebral hemorrhage.

作者信息

Hu Zhaosuo, Sha Quan

机构信息

School of Basic Medicine, Anhui Medical University, Hefei, Anhui, China.

Department of Clinical Laboratory, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.

出版信息

Front Neurol. 2024 Aug 2;15:1410569. doi: 10.3389/fneur.2024.1410569. eCollection 2024.

DOI:10.3389/fneur.2024.1410569
PMID:39157063
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11327125/
Abstract

AIM

This study aimed to analyze the association between serum osmolality and the risk of in-hospital mortality in intracerebral hemorrhage (ICH) patients.

METHODS

In this retrospective cohort study, data of a total of 1,837 ICH patients aged ≥18 years were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV). Serum osmolality and blood urea nitrogen (BUN)-to-creatinine (Cr) ratio (BCR) were used as the main variables to assess their association with the risk of in-hospital mortality in ICH patients after first intensive care unit (ICU) admission using a univariable Cox model. Univariable and multivariable Cox regression analyses were applied to explore the associations between serum osmolality, BCR, and in-hospital mortality of ICH patients. Hazard ratio (HR) and 95% confidence intervals (CIs) were calculated.

RESULTS

The median survival duration of all participants was 8.29 (4.61-15.24) days. Serum osmolality of ≥295 mmol/L was correlated with an increased risk of in-hospital mortality in patients with ICH (HR = 1.43, 95%CI: 1.14-1.78). BCR of >20 was not significantly associated with the risk of in-hospital mortality in ICH patients. A subgroup analysis indicated an increased risk of in-hospital mortality among ICH patients who were women, belonged to white or Black race, or had complications with acute kidney injury (AKI).

CONCLUSION

High serum osmolality was associated with an increased risk of in-hospital mortality among ICH patients.

摘要

目的

本研究旨在分析血清渗透压与脑出血（ICH）患者院内死亡风险之间的关联。

方法

在这项回顾性队列研究中，从重症监护医学信息数据库-IV（MIMIC-IV）中提取了总共1837例年龄≥18岁的ICH患者的数据。血清渗透压和血尿素氮（BUN）与肌酐（Cr）比值（BCR）被用作主要变量，使用单变量Cox模型评估它们与首次入住重症监护病房（ICU）后ICH患者院内死亡风险的关联。应用单变量和多变量Cox回归分析来探讨血清渗透压、BCR与ICH患者院内死亡率之间的关联。计算风险比（HR）和95%置信区间（CI）。

结果

所有参与者的中位生存时间为8.29（4.61-15.24）天。血清渗透压≥295 mmol/L与ICH患者院内死亡风险增加相关（HR = 1.43，95%CI：1.14-1.78）。BCR>20与ICH患者院内死亡风险无显著关联。亚组分析表明，女性、属于白人或黑人种族或有急性肾损伤（AKI）并发症的ICH患者院内死亡风险增加。

结论

高血清渗透压与ICH患者院内死亡风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2962/11327125/c316cf54df25/fneur-15-1410569-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2962/11327125/7035b9b08631/fneur-15-1410569-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2962/11327125/c316cf54df25/fneur-15-1410569-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2962/11327125/7035b9b08631/fneur-15-1410569-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2962/11327125/c316cf54df25/fneur-15-1410569-g002.jpg

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