乳酸清除率能否预测肺栓塞的短期死亡率?

Yavuz Selim Benzer, Gülşen Çığşar, Bedriye Müge Sönmez
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引用次数: 0

摘要

血浆乳酸水平≥2 mmol/L可预测肺栓塞(PE)相关的不良预后,但这也引发了一个问题,即监测乳酸浓度是否比单次测量更可靠。使用乳酸浓度的重复评估来预测这类患者的结果可能更有益处。本研究旨在探讨乳酸清除率(LC)对急诊科(ED)确诊的 PE 患者短期死亡率的预测价值。一项前瞻性横断面研究在一家三级医院的急诊科进行。被诊断为 PE 的 18 岁以上患者被纳入研究。研究人员记录了入院时的危险因素、生命体征和乳酸水平(到达时和第二小时)。计算患者的肺栓塞严重程度指数(PESI)得分。评估患者的 24 小时、7 天和 30 天存活率。随后,77 名患者被纳入研究。研究发现,PESI 评分、基础乳酸水平和第 2 小时乳酸水平对预测 30 天死亡率有显著作用(P = 0.002、0.009 和 0.002)。PESI、基础和第 2 小时乳酸水平的接收者操作特征(ROC)曲线分析显示,曲线下面积(AUC)分别为 0.703(95% CI:0.586-0.820)、0.688(95% CI:0.552-0.824)和 0.722(95% CI:0.586-0.857)。PESI、基础和第 2 小时乳酸水平的预测效果相似。乳酸浓度对预测 30 天死亡率无显著影响(P = 0.290)。乳酸浓度与 PE 患者的死亡率无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Does Lactate Clearance Predict Short-Term Mortality in Pulmonary Embolism?

Does Lactate Clearance Predict Short-Term Mortality in Pulmonary Embolism?

Plasma lactate level of ≥ 2 mmol/L can predict pulmonary embolism (PE)-associated adverse outcomes but has led to the question of if monitoring lactate concentration can be more reliable than the adequacy of a single measurement. It could be more beneficial to use repeated assessments of lactate concentration to forecast results in this patient group. This study aims to investigate the predictive value of lactate clearance (LC) in short-term mortality in patients diagnosed with PE in the emergency department (ED). A prospective cross-sectional study was conducted in ED of a tertiary care hospital. Patients who were diagnosed with PE over age 18 were enrolled in the study. The risk factors, vital signs, and lactate levels (at arrival and the 2nd hour) at admission were recorded. The Pulmonary Embolism Severity Index (PESI) scores of the patients were calculated. The 24-h, 7-d, and 30-d survival rates of the patients were evaluated. Then, 77 patients were included in the study. PESI score, basal, and 2nd-hour lactate levels were found significant in predicting 30-day mortality (p = 0.002, 0.009, and 0.002, respectively). Receiver operating characteristic (ROC) curve analyses for PESI, basal, and 2nd-hour lactate levels showed an area under curve (AUC) of 0.703 (95% CI: 0.586–0.820), 0.688 (95% CI: 0.552–0.824), and 0.722 (95% CI: 0.586–0.857), respectively. The predictive performances of PESI, basal, and 2nd-hour lactate level were similar. LC was not significant in predicting the 30-day mortality (p = 0.290). LC was not correlated with mortality in patients with PE.

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