重症监护病房中患有慢性阻塞性肺病的充血性心力衰竭患者的收缩压与院内死亡率之间的关系:回顾性队列研究

IF 2.8 3区 医学 Q1 Medicine
Kai Zhang, Yu Han, Yu Xuan Gao, Fang Ming Gu, Zhao Xuan Gu, Jia Ying Liang, Jia Yu Zhao, Tianqi Zhang, Min Gao, Tian Yi Cai, Rui Hu, Tian Zhou Liu, Bo Li, Yixin Zhang
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引用次数: 0

摘要

背景:针对入住重症监护室(ICU)的充血性心力衰竭(CHF)和慢性阻塞性肺病(COPD)患者的研究越来越多。然而,此类患者的最佳血压(BP)水平仍未得到充分探讨。本研究旨在探讨同时患有慢性阻塞性肺病(CHF)和慢性阻塞性肺病(COPD)的重症监护病房患者的收缩压(SBP)与院内死亡率之间的关系:这项回顾性队列研究从重症监护医学信息市场 IV(MIMIC-IV)数据库中纳入了 6309 名患者。SBP既是连续变量,也是分类变量,主要结果是院内死亡率。调查包括多变量逻辑回归、限制性三次样条回归和亚组分析,以确定 SBP 与死亡率之间的关系:队列由 6309 名同时患有慢性心力衰竭和慢性阻塞性肺病的患者组成(女性 3246 人,男性 3063 人),平均年龄为 73.0 ± 12.5 岁。多变量分析显示,无论是作为连续变量(几率比=0.99 [95% CI, 0.99~1])还是作为分类变量(分为五等分),SBP 与院内死亡率之间均呈负相关。限制性三次样条分析表明,SBP 与死亡风险之间呈 L 型关系(P 非线性 < 0.001),拐点为 99.479 mmHg。分层分析进一步证实了这种相关性的稳健性:结论:CHF 和 COPD 患者的 SBP 与院内死亡率之间的关系呈 L 型,拐点约为 99.479 mmHg。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association Between Systolic Blood Pressure and in-Hospital Mortality Among Congestive Heart Failure Patients with Chronic Obstructive Pulmonary Disease in the Intensive Care Unit: A Retrospective Cohort Study
Background: There has been a growing body of research focusing on patients with Congestive Heart Failure (CHF) and chronic obstructive pulmonary disease (COPD) admitted to the intensive care unit (ICU). However, the optimal blood pressure (BP) level for such patients remains insufficiently explored. This study aimed to investigate the associations between systolic blood pressure (SBP) and in-hospital mortality among ICU patients with both CHF and COPD.
Methods: This retrospective cohort study enrolled 6309 patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. SBP was examined as both a continuous and categorical variable, with the primary outcome being in-hospital mortality. The investigation involved multivariable logistic regression, restricted cubic spline regression, and subgroup analysis to determine the relationship between SBP and mortality.
Results: The cohort consisted of 6309 patients with concurrent CHF and COPD (3246 females and 3063 males), with an average age of 73.0 ± 12.5 years. The multivariate analysis revealed an inverse association between SBP and in-hospital mortality, both as a continuous variable (odds ratio = 0.99 [95% CI, 0.99~1]) and as a categorical variable (divided into quintiles). Restricted cubic spline analysis demonstrated an L-shaped relationship between SBP and mortality risk (P nonlinearity < 0.001), with an inflection point at 99.479 mmHg. Stratified analyses further supported the robustness of this correlation.
Conclusion: The relationship between SBP and in-hospital mortality in patients with both CHF and COPD follows an L-shaped pattern, with an inflection point at approximately 99.479 mmHg.

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来源期刊
CiteScore
5.10
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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