重症监护病房入院时磷钙比值与急性胰腺炎全因死亡率之间的关联：来自MIMIC-IV数据库的见解

Association between phosphorus-to-calcium ratio at ICU admission and all-cause mortality in acute pancreatitis: Insights from the MIMIC-IV database.

作者信息

Han Yimin, Chen Fan, Wei Wanzhen, Zeng Jiahui, Song Yiqun, Wang Zheng, Cao Fang, Wang Yaochun, Xu Kedong, Ma Zhenhua

机构信息

Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.

Pancreatic Disease Center of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.

出版信息

J Hepatobiliary Pancreat Sci. 2025 Mar;32(3):228-237. doi: 10.1002/jhbp.12094. Epub 2024 Dec 23.

DOI:10.1002/jhbp.12094

PMID:39711358

Abstract

BACKGROUND

Serum phosphorus and serum calcium are important electrolytes in the body. The relationship between them and acute pancreatitis (AP) has been previously discussed. However, the results seem to lack credibility due to the neglect of mutual influence between them. Thus, a comprehensive indicator is needed.

METHODS

In this study, AP patients with intensive care unit (ICU) treatment were extracted from Medical Information Mart for Intensive Care (MIMIC) database. The outcomes included in-hospital mortality and ICU mortality. Kaplan-Meier survival analysis, Cox proportional hazard regression model and restricted cubic spline were employed to investigate the association between the phosphorus-to-calcium ratio (PCR) index and clinical outcomes.

RESULTS

A total of 719 AP patients (57.2% male) were enrolled. The in-hospital and ICU mortality were 11.4% and 7.5%, respectively. After adjusting for confounders, Cox proportional hazard analysis indicated patients with a higher PCR index had a significant association with in-hospital mortality (adjusted hazard ratio, 2.88; 95% confidence interval, 1.34-6.19; p = .007). Restricted cubic splines revealed that a progressively increasing risk of all-cause mortality was associated with an elevated PCR index.

CONCLUSION

The PCR index has a strong correlation with in-hospital and ICU all-cause mortality in AP, which provides a reference for clinical decision-making.

摘要

背景

血清磷和血清钙是人体重要的电解质。此前已讨论过它们与急性胰腺炎（AP）之间的关系。然而，由于忽视了它们之间的相互影响，结果似乎缺乏可信度。因此，需要一个综合指标。

方法

在本研究中，从重症监护医学信息数据库（MIMIC）中提取接受重症监护病房（ICU）治疗的AP患者。结局指标包括院内死亡率和ICU死亡率。采用Kaplan-Meier生存分析、Cox比例风险回归模型和限制性立方样条来研究磷钙比（PCR）指数与临床结局之间的关联。

结果

共纳入719例AP患者（男性占57.2%）。院内死亡率和ICU死亡率分别为11.4%和7.5%。在调整混杂因素后，Cox比例风险分析表明，PCR指数较高的患者与院内死亡率显著相关（调整后风险比为2.88；95%置信区间为1.34-6.19；p = 0.007）。限制性立方样条显示，PCR指数升高与全因死亡率风险逐渐增加相关。