重症监护病房心力衰竭患者白蛋白-胆红素（ALBI）评分与全因死亡风险的关系

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2024-12-19 eCollection Date: 2024-01-01 DOI:10.5334/gh.1379

Jiuyi Wang, Kai Wang, Guibo Feng, Xin Tian

{"title":"重症监护病房心力衰竭患者白蛋白-胆红素（ALBI）评分与全因死亡风险的关系","authors":"Jiuyi Wang, Kai Wang, Guibo Feng, Xin Tian","doi":"10.5334/gh.1379","DOIUrl":null,"url":null,"abstract":"Background: The albumin-bilirubin (ALBI) score has demonstrated prognostic value in a range for liver and heart diseases. However, its association with all-cause mortality in intensive care unit (ICU) patients with heart failure remains uncertain.Objective: This study sought to investigate the relationship between the ALBI score and the risk of all-cause mortality in ICU patients with heart failure.Methods and results: The ICU patients diagnosed with heart failure were selected from the Medical Information Mart for Intensive Care IV database (MIMIC-IV, version 2.2) and stratified into tertiles according to their ALBI scores. The primary outcome of interest was the occurrence of all-cause mortality within 365 days post-discharge. The analysis encompassed a cohort of 4,239 patients, with Kaplan-Meier curves indicating that individuals with higher ALBI levels exhibited an elevated risk of all-cause mortality (log-rank p < 0.001). Multivariate adjusted Cox regression and subgroup analysis demonstrated that individuals in T2 (hazard ratio (HR) 1.09, 95% CI 0.99-1.21) and T3 (HR 1.17, 95% CI 1.02-1.34) had an increased risk of mortality compared to individuals in T1 (p for trend < 0.001), and each incremental tertile in ALBI was linked to a 10% rise in mortality risk, while each individual unit increase in ALBI was associated with a 36% increase in mortality risk. This relationship was consistently observed across most subgroups, except for using or not using inotropes or vasopressors, different ages, different creatinine levels. The restricted cubic spline (RCS) analysis indicated a linear relationship between ALBI levels and the risk of all-cause mortality.Conclusion: The ALBI scores are independently associated with the risk of all-cause mortality in ICU patients with heart failure, particularly in those not using inotropes or vasopressors, younger patients, and with lower levels of creatinine. ALBI may help identify high-risk patients and optimize risk stratification in this population.","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"19 1","pages":"97"},"PeriodicalIF":3.0000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661052/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association Between the Albumin-Bilirubin (ALBI) Score and All-cause Mortality Risk in Intensive Care Unit Patients with Heart Failure.\",\"authors\":\"Jiuyi Wang, Kai Wang, Guibo Feng, Xin Tian\",\"doi\":\"10.5334/gh.1379\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: The albumin-bilirubin (ALBI) score has demonstrated prognostic value in a range for liver and heart diseases. However, its association with all-cause mortality in intensive care unit (ICU) patients with heart failure remains uncertain.Objective: This study sought to investigate the relationship between the ALBI score and the risk of all-cause mortality in ICU patients with heart failure.Methods and results: The ICU patients diagnosed with heart failure were selected from the Medical Information Mart for Intensive Care IV database (MIMIC-IV, version 2.2) and stratified into tertiles according to their ALBI scores. The primary outcome of interest was the occurrence of all-cause mortality within 365 days post-discharge. The analysis encompassed a cohort of 4,239 patients, with Kaplan-Meier curves indicating that individuals with higher ALBI levels exhibited an elevated risk of all-cause mortality (log-rank p < 0.001). Multivariate adjusted Cox regression and subgroup analysis demonstrated that individuals in T2 (hazard ratio (HR) 1.09, 95% CI 0.99-1.21) and T3 (HR 1.17, 95% CI 1.02-1.34) had an increased risk of mortality compared to individuals in T1 (p for trend < 0.001), and each incremental tertile in ALBI was linked to a 10% rise in mortality risk, while each individual unit increase in ALBI was associated with a 36% increase in mortality risk. This relationship was consistently observed across most subgroups, except for using or not using inotropes or vasopressors, different ages, different creatinine levels. The restricted cubic spline (RCS) analysis indicated a linear relationship between ALBI levels and the risk of all-cause mortality.Conclusion: The ALBI scores are independently associated with the risk of all-cause mortality in ICU patients with heart failure, particularly in those not using inotropes or vasopressors, younger patients, and with lower levels of creatinine. ALBI may help identify high-risk patients and optimize risk stratification in this population.\",\"PeriodicalId\":56018,\"journal\":{\"name\":\"Global Heart\",\"volume\":\"19 1\",\"pages\":\"97\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-12-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661052/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Heart\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5334/gh.1379\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Heart","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5334/gh.1379","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景：白蛋白-胆红素（ALBI）评分在一系列肝脏和心脏疾病中显示出预后价值。然而，其与重症监护病房（ICU）心力衰竭患者全因死亡率的关系仍不确定。目的：探讨ICU心力衰竭患者ALBI评分与全因死亡风险的关系。方法与结果：从重症监护医学信息市场IV数据库（MIMIC-IV, version 2.2）中选择诊断为心力衰竭的ICU患者，根据其ALBI评分进行分层。主要观察指标为出院后365天内的全因死亡率。该分析包括4239例患者，Kaplan-Meier曲线显示ALBI水平较高的个体表现出全因死亡率升高的风险（log-rank p < 0.001）。多因素校正Cox回归和亚组分析表明，T2（风险比1.09,95% CI 0.99-1.21）和T3（风险比1.17,95% CI 1.02-1.34）的个体与T1（趋势p < 0.001）的个体相比，死亡风险增加（趋势p < 0.001）， ALBI每增加1个单位与死亡风险增加10%相关，而ALBI每增加1个单位与死亡风险增加36%相关。除了使用或不使用肌力药物或血管加压药物、不同年龄、不同肌酐水平外，这种关系在大多数亚组中一致观察到。限制性三次样条（RCS）分析显示ALBI水平与全因死亡风险之间存在线性关系。结论：ALBI评分与ICU心力衰竭患者的全因死亡风险独立相关，特别是那些不使用收缩性药物或血管加压药物的患者、年轻患者和肌酐水平较低的患者。ALBI可能有助于识别高危患者并优化该人群的风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Association Between the Albumin-Bilirubin (ALBI) Score and All-cause Mortality Risk in Intensive Care Unit Patients with Heart Failure.

Background: The albumin-bilirubin (ALBI) score has demonstrated prognostic value in a range for liver and heart diseases. However, its association with all-cause mortality in intensive care unit (ICU) patients with heart failure remains uncertain.

Objective: This study sought to investigate the relationship between the ALBI score and the risk of all-cause mortality in ICU patients with heart failure.

Methods and results: The ICU patients diagnosed with heart failure were selected from the Medical Information Mart for Intensive Care IV database (MIMIC-IV, version 2.2) and stratified into tertiles according to their ALBI scores. The primary outcome of interest was the occurrence of all-cause mortality within 365 days post-discharge. The analysis encompassed a cohort of 4,239 patients, with Kaplan-Meier curves indicating that individuals with higher ALBI levels exhibited an elevated risk of all-cause mortality (log-rank p < 0.001). Multivariate adjusted Cox regression and subgroup analysis demonstrated that individuals in T2 (hazard ratio (HR) 1.09, 95% CI 0.99-1.21) and T3 (HR 1.17, 95% CI 1.02-1.34) had an increased risk of mortality compared to individuals in T1 (p for trend < 0.001), and each incremental tertile in ALBI was linked to a 10% rise in mortality risk, while each individual unit increase in ALBI was associated with a 36% increase in mortality risk. This relationship was consistently observed across most subgroups, except for using or not using inotropes or vasopressors, different ages, different creatinine levels. The restricted cubic spline (RCS) analysis indicated a linear relationship between ALBI levels and the risk of all-cause mortality.

Conclusion: The ALBI scores are independently associated with the risk of all-cause mortality in ICU patients with heart failure, particularly in those not using inotropes or vasopressors, younger patients, and with lower levels of creatinine. ALBI may help identify high-risk patients and optimize risk stratification in this population.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.