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血清乳酸脱氢酶水平与 ICU 脓毒症患者住院死亡率之间的正相关性:来自两个大型数据库的证据。

A positive correlation between serum lactate dehydrogenase level and in-hospital mortality in ICU sepsis patients: evidence from two large databases.

机构信息

Department of Critical Care, The Second Affiliated Hospital of Guangzhou Medical University, No. 250 Changgang East Road, Haizhu District, Guangzhou, China.

出版信息

Eur J Med Res. 2024 Nov 1;29(1):525. doi: 10.1186/s40001-024-02071-4.

Abstract

BACKGROUND

Sepsis presents a significant healthcare challenge, characterized by high morbidity and mortality rates. There is a scarcity of relevant studies investigating the association between serum lactate dehydrogenase level and the prognosis of sepsis in patients from intensive care unit, with smaller sample sizes compared to other studies.

METHODS

A retrospective analysis was conducted utilizing data from the Second Affiliated Hospital of Guangzhou Medical University and the Medical Information Mart for Intensive Care IV (MIMIC-IV). The primary outcome was the in-hospital mortality. Multivariate Cox proportional hazards regression was adopted to assess the independent association. Receiver operator characteristic (ROC) curve was used to evaluate the predictive value.

RESULTS

We included a total of 2148 patients in the Guangzhou Sepsis Cohort (GZSC) database and 5830 patients in the MIMIC-IV database. In multivariate Cox proportional hazards regression, high levels of LDH are significantly associated with higher mortality (HR = 1.21, 95% CI 1.13-1.30, p < 0.001 in the GZSC database and HR = 1.19, 95% CI 1.13-1.25, p < 0.001 in the MIMIC-IV database). The ROC curves showed that the AUC of LDH was 0.663 in the GZSC database and 0.660 in the MIMIC-IV database.

CONCLUSIONS

A lower lactate dehydrogenase level is associated with reduced in-hospital mortality among patients with sepsis, suggesting its potential as a valuable marker for predicting prognosis in this patient population.

摘要

背景

脓毒症是一个重大的医疗保健挑战,其特点是发病率和死亡率高。与其他研究相比,针对重症监护病房脓毒症患者血清乳酸脱氢酶水平与预后之间的相关性,相关研究较少,且样本量较小。

方法

利用广州医科大学第二附属医院和医学信息监护 IV(MIMIC-IV)的数据进行回顾性分析。主要结局是院内死亡率。采用多变量 Cox 比例风险回归评估独立相关性。采用接收者操作特征(ROC)曲线评估预测价值。

结果

我们纳入了广州脓毒症队列(GZSC)数据库中的 2148 例患者和 MIMIC-IV 数据库中的 5830 例患者。多变量 Cox 比例风险回归显示,高水平的 LDH 与更高的死亡率显著相关(GZSC 数据库中的 HR=1.21,95%CI 1.13-1.30,p<0.001;MIMIC-IV 数据库中的 HR=1.19,95%CI 1.13-1.25,p<0.001)。ROC 曲线显示,LDH 的 AUC 在 GZSC 数据库中为 0.663,在 MIMIC-IV 数据库中为 0.660。

结论

脓毒症患者乳酸脱氢酶水平较低与院内死亡率降低相关,表明其可能是预测该患者人群预后的有价值标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3883/11531135/ad92cdc23c3a/40001_2024_2071_Fig1_HTML.jpg

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