Gianni Turcato, Arian Zaboli, Serena Sibilio, Michael Mian, Francesco Brigo
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引用次数: 0
摘要
对于急诊脓毒症患者,早期风险分层对改善预后很重要。该研究旨在评估估计血浆容量(ePVS)在急诊科入院时的预测作用。该前瞻性研究纳入了2021年入住急诊科的所有败血症患者。采用调整患者临床特征的多变量模型来评估ePVS对独立预测30天死亡的贡献。共有455例脓毒症患者入组,16.9%的患者死亡。存活至30天的患者平均ePVS为5.19,而30天死亡的患者平均ePVS为5.74 (p=0.004)。ePVS是30天死亡率的独立危险因素,调整后OR为1.211 (95% CI 1.004-1.460, p=0.045)。ePVS的AUROC为0.619 (95% CI 0.545-0.689)。决策树分析显示ePVS在较轻重症患者中的预测作用。在脓毒症患者中,ePVS是30天死亡率的独立预测指标,并可改善病情较轻患者的风险预测。
Estimated plasma volume status can help identify patients with sepsis at risk of death within 30 days in the emergency department
For patients with sepsis in the Emergency Department (ED), early risk stratification is important to improve prognosis. The study aimed to evaluate the predictive role of estimated plasma volume (ePVS) on admission to the ED. All sepsis patients who were admitted to our ED in 2021, were included in this prospective study. Multivariate models adjusted for patients' clinical characteristics were used to assess the contribution of ePVS to the independent prediction of death at 30 days. A total of 455 septic patients were enrolled and 16.9% of patients died. Patients who survived to 30 days had a mean ePVS of 5.19, while those who died at 30 days had a value of 5.74 (p=0.004). ePVS was an independent risk factor for 30-day mortality with an adjusted OR of 1.211 (95% CI 1.004–1.460, p=0.045). The AUROC of ePVS was 0.619 (95% CI 0.545–0.689). Decision tree analysis showed a predictive role for ePVS in less severe patients. In septic patients, ePVS is an independent predictor of 30-day mortality and may improve risk prediction in less severe patients.