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并存的代谢功能障碍相关脂肪性肝病会加重中暑患者的院内结局。

Coexisting metabolic dysfunction-associated steatotic liver disease exacerbates in-hospital outcomes in patients with heat stroke.

作者信息

Zhang Ping, Tang Guo, Gao Hongguang, Zhang Tianshan, Yang Sha, Cheng Tao, Yao Rong

机构信息

Emergency Department of West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Med (Lausanne). 2024 Nov 12;11:1451133. doi: 10.3389/fmed.2024.1451133. eCollection 2024.

Abstract

PURPOSE

This study aimed to investigate the impact of coexisting metabolic dysfunction-associated steatotic liver disease (MASLD) on in-hospital mortality and organ injury markers in patients with heat stroke (HS).

APPROACH

HS patients were retrospectively identified between July 1, 2022 and September 30, 2023 at West China Hospital, Sichuan University. Baseline characteristics, such as demographics, initial vital signs, and organ functional indicators were collected. Outcome events included organ injury and in-hospital mortality. The Least Absolute Shrinkage and Selection Operator (Lasso) method was employed to identify the optimal predictors for in-hospital mortality in HS patients. Subsequently, multivariable logistic regression analysis was performed to assess the relationship between the presence of MASLD and in-hospital mortality as well as organ function indicators.

FINDINGS

A total of 112 patients were included in the study, in which 27 (24.1%) had coexisting MASLD. Compared to those without MASLD, patients with MASLD had higher levels of various organ injury markers such as aspartate aminotransferase, urea nitrogen, serum cystatin C, creatinine, uric acid, myoglobin, creatine kinase and its isoenzymes upon admission ( < 0.05). The multivariable Logistic regression analysis indicated that the presence of MASLD is an independent risk factor for in-hospital mortality in HS patients.

CONCLUSION

This study firstly indicated that coexisting MASLD may exacerbate organ injury in HS patients and serve as an independent risk factor for in-hospital mortality.

摘要

目的

本研究旨在探讨并存的代谢功能障碍相关脂肪性肝病(MASLD)对中暑(HS)患者院内死亡率和器官损伤标志物的影响。

方法

回顾性纳入2022年7月1日至2023年9月30日在四川大学华西医院就诊的HS患者。收集人口统计学、初始生命体征和器官功能指标等基线特征。结局事件包括器官损伤和院内死亡。采用最小绝对收缩和选择算子(Lasso)方法确定HS患者院内死亡的最佳预测因素。随后,进行多变量逻辑回归分析,以评估MASLD的存在与院内死亡率以及器官功能指标之间的关系。

结果

本研究共纳入112例患者,其中27例(24.1%)并存MASLD。与无MASLD的患者相比,并存MASLD的患者入院时各种器官损伤标志物如天冬氨酸转氨酶、尿素氮、血清胱抑素C、肌酐、尿酸、肌红蛋白、肌酸激酶及其同工酶水平更高(<0.05)。多变量逻辑回归分析表明,MASLD的存在是HS患者院内死亡的独立危险因素。

结论

本研究首次表明,并存MASLD可能会加重HS患者的器官损伤,并作为院内死亡的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e97/11588490/a8c12b1a3eb9/fmed-11-1451133-g001.jpg

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