D-二聚体与白蛋白比值作为脓毒症重症患者预后生物标志物的价值：一项回顾性单中心研究。
The value of D-dimer-albumin ratio as a prognostic biomarker in critically ill patients with sepsis: A retrospective single-center study.
作者信息
Zhang Jinhui, Song Chao, Hu Zhenkui
机构信息
Department of Critical Care Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212001, China.
Department of Emergency Medicine, The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212001, China.
出版信息
Heliyon. 2024 Oct 9;10(20):e39057. doi: 10.1016/j.heliyon.2024.e39057. eCollection 2024 Oct 30.
BACKGROUND
This study aimed to examine the potential prognostic significance of the D-dimer-albumin ratio (DAR) in critically ill patients with sepsis.
METHODS
A retrospective cohort study was carried out at the Affiliated Hospital of Jiangsu University, involving 1123 patients diagnosed with sepsis from January 2015 to November 2023. The patients were categorized into four groups (Q1-Q4) based on their DAR levels. The primary outcomes measured were in-hospital mortality and ICU mortality. Survival analysis was conducted using Kaplan-Meier survival curves and the log-rank test. Additionally, Cox proportional hazards regression models were utilized to investigate the relationship between the DAR and all-cause mortality.
RESULTS
The study population had a median age of 75 years (interquartile range: 65-84), and the median DAR was 0.15 (interquartile range: 0.08-0.32). The rates of hospital mortality and ICU mortality were 33.7 % and 31.9 % respectively. There was an observed increase in the cumulative incidence of 30-/60-day mortality with higher DAR levels (log-rank test, P < 0.001). After accounting for other variables, the results from multivariable Cox proportional hazards analyses demonstrated that DAR independently predicted hospital death [HR (95%CI): 1.419 (1.205-1.670); P < 0.001] and ICU death [HR (95%CI): 1.437 (1.219-1.693); P < 0.001].
CONCLUSIONS
The DAR was found to be an independent predictor of all-cause mortality in critically ill patients with sepsis.
背景
本研究旨在探讨D - 二聚体与白蛋白比值（DAR）在脓毒症重症患者中的潜在预后意义。
方法
在江苏大学附属医院开展一项回顾性队列研究，纳入2015年1月至2023年11月诊断为脓毒症的1123例患者。根据DAR水平将患者分为四组（Q1 - Q4）。主要观察指标为住院死亡率和重症监护病房（ICU）死亡率。采用Kaplan - Meier生存曲线和对数秩检验进行生存分析。此外，利用Cox比例风险回归模型研究DAR与全因死亡率之间的关系。
结果
研究人群的中位年龄为75岁（四分位间距：65 - 84岁），中位DAR为0.15（四分位间距：0.08 - 0.32）。住院死亡率和ICU死亡率分别为33.7%和31.9%。观察到随着DAR水平升高，30/60天死亡率的累积发生率增加（对数秩检验，P < 0.001）。在考虑其他变量后，多变量Cox比例风险分析结果表明，DAR可独立预测医院死亡[风险比（95%置信区间）：1.419（1.205 - 1.670）；P < 0.001]和ICU死亡[风险比（95%置信区间）：1.437（1.219 - 1.693）；P < 0.001]。
结论
发现DAR是脓毒症重症患者全因死亡率的独立预测指标。
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