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ICU 心力衰竭患者乳酸脱氢酶水平与全因死亡率之间的关联:MIMIC-IV 数据库的回顾性分析

Association between lactate dehydrogenase levels and all-cause mortality in ICU patients with heart failure: a retrospective analysis of the MIMIC-IV database.

作者信息

Guo Panxu, Ding Hongfu, Li Xiaowan, Xie Danying, Wang Ke, Su Wanmin, Yang XiaoJuan, Nie Fang, Wang Peixi

机构信息

Nanhai Family Practice Hospital, Foshan, Guangdong, 528200, People's Republic of China.

School of Nursing and Health, Henan University, Kaifeng, Henan, 475004, People's Republic of China.

出版信息

BMC Cardiovasc Disord. 2025 Jan 29;25(1):62. doi: 10.1186/s12872-025-04513-1.

Abstract

BACKGROUND

Heart failure (HF) patients admitted to the intensive care unit (ICU) often face high short-term mortality rates. This study aims to investigate the relationship between lactate dehydrogenase (LDH) levels and all-cause mortality in critically ill patients with HF.

METHODS

Data from the MIMIC-IV database were extracted for subjects eligible for HF diagnosis. We utilized the restricted cubic spline (RCS) method, Kaplan-Meier (K-M) survival curves, and Cox regression analysis to assess the association between lactate dehydrogenase (LDH) levels and all-cause mortality in HF patients. Overlap weighting (OW) and subgroup analysis were employed to enhance the robustness and reliability of the study.

RESULTS

A total of 3,065 subjects were enrolled in this study. RCS analysis revealed a nonlinear relationship between LDH levels and the risk of all-cause mortality in critically ill patients with HF, with a hazard ratio (HR) > 1 when LDH exceeded 315 U/L. The K-M survival curve indicated lower survival rates and shorter survival times in subjects with LDH ≥ 315 U/L. Elevated LDH levels were independently associated with increased in-hospital and 1-year mortality rates, with adjusted HR of 1.39 (95% CI: 1.16, 1.67) and 1.29 (95% CI: 1.14, 1.45), respectively. The results remained consistently robust in the OW analyses.

CONCLUSIONS

Elevated LDH levels were significantly associated with an increased risk of all-cause mortality in ICU-admitted HF patients. Further randomized trials are needed to confirm this association.

摘要

背景

入住重症监护病房(ICU)的心力衰竭(HF)患者往往面临较高的短期死亡率。本研究旨在探讨乳酸脱氢酶(LDH)水平与重症HF患者全因死亡率之间的关系。

方法

从MIMIC-IV数据库中提取符合HF诊断标准的受试者数据。我们采用受限立方样条(RCS)法、Kaplan-Meier(K-M)生存曲线和Cox回归分析来评估HF患者乳酸脱氢酶(LDH)水平与全因死亡率之间的关联。采用重叠加权(OW)和亚组分析来增强研究的稳健性和可靠性。

结果

本研究共纳入3065名受试者。RCS分析显示,在重症HF患者中,LDH水平与全因死亡风险之间存在非线性关系,当LDH超过315 U/L时,风险比(HR)>1。K-M生存曲线表明,LDH≥315 U/L的受试者生存率较低,生存时间较短。LDH水平升高与住院死亡率和1年死亡率增加独立相关,调整后的HR分别为1.39(95%CI:1.16,1.67)和1.29(95%CI:1.14,1.45)。在OW分析中,结果始终保持稳健。

结论

LDH水平升高与入住ICU的HF患者全因死亡风险增加显著相关。需要进一步的随机试验来证实这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb13/11776202/20348af7976a/12872_2025_4513_Fig1_HTML.jpg

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