Catecholamine concentration as a predictor of mortality in emergency surgical patients.

IF 2 Q2 EMERGENCY MEDICINE

International Journal of Emergency Medicine Pub Date : 2024-07-18 DOI:10.1186/s12245-024-00676-4

João Isuk Suh, Daiane Leite da Roza, Filipe Matheus Cadamuro, Luiz Marcelo Sá Malbouisson, Talita Rojas Sanches, Lúcia Andrade

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引用次数: 0

Abstract

Background: Trauma and emergency surgery are major causes of morbidity and mortality. The objective of this study was to determine whether serum levels of epinephrine and norepinephrine are associated with aging and mortality.

Methods: This was a prospective observational cohort study conducted in a surgical critical care unit. We included 90 patients who were admitted for postoperative care, because of major trauma, or both. We collected demographic and clinical variables, as well as serum levels of epinephrine and norepinephrine.

Results: For patients in the > 60-year age group, the use of vasoactive drugs was found to be associated with an undetectable epinephrine level (OR [95% CI] = 6.36 [1.12, 36.08]), p = 0.05). For the patients with undetectable epinephrine levels, the in-hospital mortality was higher among those with a norepinephrine level ≥ 2006.5 pg/mL (OR [95% CI] = 4.00 [1.27, 12.58]), p = 0.03).

Conclusions: There is an association between age and mortality. Undetectable serum epinephrine, which is more common in older patients, could contribute to poor outcomes. The use of epinephrine might improve the clinical prognosis in older surgical patients with shock.

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儿茶酚胺浓度可预测急诊外科手术患者的死亡率。

背景：创伤和急诊手术是发病和死亡的主要原因。本研究旨在确定血清中肾上腺素和去甲肾上腺素的水平是否与衰老和死亡率有关：这是一项在外科重症监护病房进行的前瞻性观察性队列研究。我们纳入了 90 名因术后护理、重大创伤或两者兼而有之而入院的患者。我们收集了人口统计学和临床变量以及血清中肾上腺素和去甲肾上腺素的水平：结果：对于年龄大于 60 岁的患者，使用血管活性药物与肾上腺素水平检测不到有关（OR [95% CI] = 6.36 [1.12, 36.08]），P = 0.05）。在肾上腺素水平检测不到的患者中，去甲肾上腺素水平≥2006.5 pg/mL的患者院内死亡率更高（OR [95% CI] = 4.00 [1.27, 12.58]），P = 0.03）：结论：年龄与死亡率之间存在关联。血清肾上腺素检测不到在老年患者中更为常见，可能会导致不良预后。使用肾上腺素可能会改善老年休克手术患者的临床预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Emergency Medicine EMERGENCY MEDICINE-

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.