在 MIMIC IV 数据库中,高钾血症与重症患者的短期和中期死亡率有关。

IF 3.9 2区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES
Chuan Xu, Yong Luo, Xiuling Chen, Yunlin Feng
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引用次数: 0

摘要

我们的目的是利用重症医疗信息市场(MIMIC-IV)数据库探讨高钾血症与危重患者中短期死亡率的关系。纳入在重症监护病房(ICU)停留至少48小时并进行血清钾检测的成年患者。高钾血症定义为血清钾高于5.5 mmol/L。暴露包括发生高钾血症的时间和血清钾的数值。结果包括ICU死亡率、ICU入院后7天和30天死亡率。根据Kaplan-Meier分析计算生存曲线。使用单因素和多因素Cox比例风险回归模型估计每次暴露的风险比(HR)和95%置信区间(CI)。完全调整后进行亚组分析。本研究共纳入22,370例ICU患者。高钾血症的患病率为18.8%。有和没有高钾血症的患者在许多基线特征上有显著差异。ICU死亡率、7天死亡率和30天死亡率分别为12.6%、9.5%和19.1%。充分调整后,高钾血症的发生与ICU死亡率密切相关(HR: 1.39;95% CI: 1.22-1.58)和30天死亡率(HR: 1.16;95% CI: 1.03-1.31)。高钾血症发生的时间也与死亡风险有关。在对人口统计学变量、临床试验和合并症进行全面调整后,这些关联在多元回归分析中保持不变。综上所述,高钾血症的发生和时间与重症患者的ICU和30天死亡率密切相关。一旦发生高钾血症,需要采取积极的干预措施,使血清钾水平尽快恢复正常,无论数值如何。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Hyperkalemia is associated with short- and mid-term mortalities in critically ill patients in the MIMIC IV database.

Hyperkalemia is associated with short- and mid-term mortalities in critically ill patients in the MIMIC IV database.

Hyperkalemia is associated with short- and mid-term mortalities in critically ill patients in the MIMIC IV database.

Hyperkalemia is associated with short- and mid-term mortalities in critically ill patients in the MIMIC IV database.

We aimed to explore the association of hyperkalemia and short- and mid-term mortality in critically ill patients using the Medical Information Mart for Intensive Care (MIMIC-IV) database. Adult patients who had been stayed in the intensive care unit (ICU) for at least 48 h and tested for serum potassium were included. Hyperkalemia was defined as serum potassium higher than 5.5 mmol/L. Exposures included the occurrence the timing of hyperkalemia and the numeric values of serum potassium. The outcomes included ICU mortality and 7 days and 30 days mortality after ICU admission. Survival curves were calculated according to Kaplan-Meier analysis. Univariate and multivariate Cox proportional hazard regression models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of each exposure for the outcomes. Subgroup analyses after full adjustment were conducted. A total of 22,370 ICU patients were included in this study. The prevalence of hyperkalemia was 18.8%. Patients with and without hyperkalemia differed significantly in a number of baseline characteristics. The ICU mortality, 7 days mortality, and 30 days mortality rates in the overall population were 12.6%, 9.5%, and 19.1%, respectively. After full adjustment, the occurrence of hyperkalemia is closely associated with the ICU mortality (HR: 1.39; 95% CI: 1.22-1.58) and 30 days mortality (HR: 1.16; 95% CI: 1.03-1.31) of the ICU patients. The timing of hyperkalemia is also associated with the risk of mortalities. These associations remained unchanged in the multiple regression analysis after full adjustment for the demographic variables, clinical tests, and comorbidities. In conclusion, the occurrence and timing of hyperkalemia are closely associated with the ICU and 30 days mortalities of critically ill patients. Once hyperkalemia occurs, active interventions are needed to restore serum potassium levels, regardless of the numeric values, to normal as quickly as possible.

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来源期刊
Scientific Reports
Scientific Reports Natural Science Disciplines-
CiteScore
7.50
自引率
4.30%
发文量
19567
审稿时长
3.9 months
期刊介绍: We publish original research from all areas of the natural sciences, psychology, medicine and engineering. You can learn more about what we publish by browsing our specific scientific subject areas below or explore Scientific Reports by browsing all articles and collections. Scientific Reports has a 2-year impact factor: 4.380 (2021), and is the 6th most-cited journal in the world, with more than 540,000 citations in 2020 (Clarivate Analytics, 2021). •Engineering Engineering covers all aspects of engineering, technology, and applied science. It plays a crucial role in the development of technologies to address some of the world''s biggest challenges, helping to save lives and improve the way we live. •Physical sciences Physical sciences are those academic disciplines that aim to uncover the underlying laws of nature — often written in the language of mathematics. It is a collective term for areas of study including astronomy, chemistry, materials science and physics. •Earth and environmental sciences Earth and environmental sciences cover all aspects of Earth and planetary science and broadly encompass solid Earth processes, surface and atmospheric dynamics, Earth system history, climate and climate change, marine and freshwater systems, and ecology. It also considers the interactions between humans and these systems. •Biological sciences Biological sciences encompass all the divisions of natural sciences examining various aspects of vital processes. The concept includes anatomy, physiology, cell biology, biochemistry and biophysics, and covers all organisms from microorganisms, animals to plants. •Health sciences The health sciences study health, disease and healthcare. This field of study aims to develop knowledge, interventions and technology for use in healthcare to improve the treatment of patients.
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