铁蛋白与白蛋白比率预测非covid -19肺炎危重患者的短期死亡率：来自MIMIC-IV数据库的回顾性队列研究

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-09-18 DOI:10.1016/j.rmed.2025.108361

Juan Feng , Tianhang Zhao , Yiyang Huang , Sien Lai , Guojun Chen

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引用次数: 0

摘要

背景：社区获得性和医院获得性肺炎是全球发病率和死亡率的重要因素，因此需要可靠的预后生物标志物。综合炎症和营养指标的铁蛋白与白蛋白比率（FAR）在COVID-19肺炎中显示出预后价值，但在非COVID-19肺炎中仍未得到充分探讨。方法：本回顾性队列研究分析了来自MIMIC-IV数据库的827例非covid -19肺炎患者。利用入院时的铁蛋白和白蛋白水平计算FAR，并将患者分层（Q1-Q3）。Cox比例风险模型评估了FAR与28天/90天死亡率之间的关系，并根据人口统计学、合并症、实验室参数和疾病严重程度评分进行了调整。结果：较高的FAR含量显著提高了28天和90天的死亡率（P < 0.05）。综合调整后，与Q1相比，最高的FAR分位数（Q3） 28天死亡风险高2.27倍（HR: 2.27, 95% CI: 1.44-3.58, P < 0.001）， 90天死亡风险高1.82倍（HR: 1.82, 95% CI: 1.27-2.61, P = 0.001）。每增加log2单位的FAR， 28天和90天的死亡风险分别增加17% （HR: 1.17, 95% CI: 1.06-1.29, P = 0.002）和14% （HR: 1.14, 95% CI: 1.06-1.24, P = 0.001）。FAR在各亚组间的预后一致性证实了其稳健性。结论：入院时FAR可作为非covid -19肺炎中短期死亡率的可靠、独立预测因子。通过协同反应过度炎症和生理储备耗竭，FAR提供了比孤立的生物标志物更强的预后效用，提供了成本效益高的风险分层工具。有必要进行前瞻性验证，以确认其临床适用性并探索far指导的治疗干预措施。

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Ferritin-to-albumin ratio predicts short-term mortality in critically ill patients with non-COVID-19 Pneumonia: A retrospective cohort study from MIMIC-IV database

Background

Community-acquired and hospital-acquired pneumonia significantly contribute to global morbidity and mortality, necessitating reliable prognostic biomarkers. The ferritin-to-albumin ratio (FAR), integrating inflammatory and nutritional markers, demonstrates prognostic value in COVID-19 pneumonia but remains underexplored in non-COVID-19 pneumonia.

Methods

This retrospective cohort study analyzed 827 non-COVID-19 pneumonia patients from the MIMIC-IV database. FAR was calculated using admission ferritin and albumin levels, with patients stratified into tertiles (Q1-Q3). Cox proportional hazards models assessed associations between FAR and 28-day/90-day mortality, adjusted for demographics, comorbidities, laboratory parameters, and disease severity scores.

Results

Higher FAR tertiles exhibited significantly increased 28-day and 90-day mortality rates (both P < 0.05). After comprehensive adjustment, the highest FAR tertile (Q3) had a 2.27-fold higher 28-day mortality risk (HR: 2.27, 95 % CI: 1.44–3.58, P < 0.001) and 1.82-fold higher 90-day mortality risk (HR: 1.82, 95 % CI: 1.27–2.61, P = 0.001) compared to Q1. Each log2-unit FAR increase independently raised 28-day and 90-day mortality risks by 17 % (HR: 1.17, 95 % CI: 1.06–1.29, P = 0.002) and 14 % (HR: 1.14, 95 % CI: 1.06–1.24, P = 0.001), respectively. FAR's prognostic consistency across subgroups confirmed its robustness.

Conclusion

FAR at admission serves as a robust, independent predictor of short- and intermediate-term mortality in non-COVID-19 pneumonia. By synergistically reflecting hyperinflammation and physiological reserve depletion, FAR provides enhanced prognostic utility over isolated biomarkers, offering a cost-effective tool for risk stratification. Prospective validation is warranted to confirm its clinical applicability and explore FAR-guided therapeutic interventions.

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.