摘要
目的基于美国大型数据库数据探讨国际标准化比值(INR)与脓毒症相关急性肾损伤(SA-AKI)患者预后的关系。方法采用回顾性队列设计,从美国重症监护医疗信息数据库Ⅳ(MIMIC-Ⅳ)2.0提取ICU入住记录的成年SA-AKI患者信息。采用限制性立方样条模型以及Cox比例风险模型来评估INR水平与住院死亡率的关系,并将其按照入住ICU后24 h内的INR的截断值进行分组绘制Kaplan-Meier生存曲线。结果高INR是SA-AKI患者死亡的独立危险因素(HR=1.73,95%CI 1.59~1.88,P<0.001),其与SA-AKI患者的预后呈非线性关系(P<0.001),截断值为1.4。结论高INR是预测SA-AKI院内死亡的独立危险因素,在SA-AKI患者的救治过程中,应重点关注INR水平和其他指标的综合评估。
Objective To investigate the correlation between the international normalized ratio(INR)and outcomes in patients with sepsis-associated acute kidney injury(SA-AKI)using data from the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ).Methods Using a retrospective queue design,information on adult SA-AKI patients with ICU admission records was extracted from the MIMIC-Ⅳ2.0.Restricted cubic spline models and multivariable Cox proportional hazards regression were employed to evaluate the nonlinear relationship between INR levels and mortality.Patients were stratified by an ICU admission 24-hour INR cutoff for Kaplan-Meier survival analysis.Results Elevated INR was independently associated with increased mortality(adjusted HR=1.73,95%CI:1.59~1.88,P<0.001),and it shows a non-linear relationship with the prognosis of SA-AKI patients(P<0.001),with a cutoff value of 1.4.Conclusion High INR is an independent risk factor for predicting in-hospital mortality in SA-AKI patients.In the treatment process of SA-AKI patients,attention should be paid to the comprehensive evaluation of INR levels and other indicators.
作者
原江东
周丽珍
段鹏程
许婕璇
黎江
卢慕荣
Yuan Jiangdong;Zhou Lizhen;Duan Pengcheng;Xu Jiexuan;Li Jiang;Lu Murong(Department of Intensive Care Unit of the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510260,China;Nursing Department of the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou Guangdong 510260,China)
出处
《中华临床实验室管理电子杂志》
2025年第1期11-16,共6页
Chinese Journal of Clinical Laboratory Management(Electronic Edition)
