住院期间血清尿素升高与院内心脏骤停后的不良预后有关

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
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引用次数: 0

摘要

评估院内心脏骤停(IHCA)患者入院时和住院期间血清尿素与自主循环恢复(ROSC)和院内死亡率之间的关系。这项回顾性研究纳入了2018年5月至2022年12月期间就诊的18岁以上IHCA患者。排除标准是没有进行计算δ尿素的检查和明确下达 "不进行复苏 "的命令。数据从电子病历中收集。还收集了入院时的血清尿素和 IHCA 前 24 小时的尿素,并用于计算 delta 尿素。共评估了 504 名患者,其中 125 名患者因缺乏计算 delta 尿素的变量而被排除,5 名患者因 "拒绝复苏 "命令而被排除。因此,我们将 374 名患者纳入了分析。平均年龄为(65.0 ± 14.5)岁,48.9%为男性,45.5%有ROSC,院内死亡率为91.7%。在逻辑回归模型中,ROSC 与 IHCA 前 24 小时尿素水平较低有关(OR:0.996;CI95%:0.992-1.000;P:0.032)。此外,IHCA 前 24 小时尿素水平升高(OR:1.020;CI95%:1.008-1.033;p:0.002)和 delta 尿素水平升高(OR:1.001;CI95%:1.001-1.019;p:0.023)与院内死亡率相关。ROC 曲线分析表明,IHCA 前 24 小时尿素的死亡率预测 ROC 曲线下面积(Cutoff > 120.1 mg/dL)高于 delta 尿素(Cutoff > 34.83 mg/dL)。总之,住院期间血清尿素水平升高与 IHCA 患者预后恶化有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum urea increase during hospital stay is associated with worse outcomes after in-hospital cardiac arrest

Background

Evaluate the association between serum urea at admission and during hospital stay with return of spontaneous circulation (ROSC) and in-hospital mortality in patients with in-hospital cardiac arrest (IHCA).

Methods

This retrospective study included patients over 18 years with IHCA attended from May 2018 to December 2022. The exclusion criteria were the absence of exams to calculate delta urea and the express order of “do-not-resuscitate”. Data were collected from the electronic medical records. Serum admission urea and urea 24 hours before IHCA were also collected and used to calculate delta urea.

Results

A total of 504 patients were evaluated; 125 patients were excluded due to the absence of variables to calculate delta urea and 5 due to “do-not-resuscitate” order. Thus, we included 374 patients in the analysis. The mean age was 65.0 ± 14.5 years, 48.9% were male, 45.5% had ROSC, and in-hospital mortality was 91.7%. In logistic regression models, ROSC was associated with lower urea levels 24 hours before IHCA (OR: 0.996; CI95%: 0.992-1.000; p: 0.032). In addition, increased levels of urea 24 hours before IHCA (OR: 1.020; CI95%: 1.008-1.033; p: 0.002) and of delta urea (OR: 1.001; CI95%: 1.001-1.019; p: 0.023) were associated with in-hospital mortality. ROC curve analysis showed that the area under the ROC curve for mortality prediction was higher for urea 24 hours before IHCA (Cutoff > 120.1 mg/dL) than for delta urea (Cutoff > 34.83 mg/dL).

Conclusions

In conclusion, increased serum urea levels during hospital stay were associated with worse prognosis in IHCA.

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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
303
审稿时长
1.5 months
期刊介绍: The American Journal of The Medical Sciences (AJMS), founded in 1820, is the 2nd oldest medical journal in the United States. The AJMS is the official journal of the Southern Society for Clinical Investigation (SSCI). The SSCI is dedicated to the advancement of medical research and the exchange of knowledge, information and ideas. Its members are committed to mentoring future generations of medical investigators and promoting careers in academic medicine. The AJMS publishes, on a monthly basis, peer-reviewed articles in the field of internal medicine and its subspecialties, which include: Original clinical and basic science investigations Review articles Online Images in the Medical Sciences Special Features Include: Patient-Centered Focused Reviews History of Medicine The Science of Medical Education.
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