影响三级转诊医院HELLP综合征患者ICU住院时间和住院时间的因素

IF 1.9 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Hypertension Pub Date : 2022-04-18 DOI:10.1155/2022/3366879

E. Ağaçayak, Rezan Buğday, Nurullah Peker, U. Değer, Gönül Ölmez Kavak, M. Evsen, T. Gul

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引用次数: 2

摘要

目的比较需要重症监护和不需要重症监护的HELLP综合征患者，评价影响重症监护时间的因素。方法将患者分为需要重症监护组(1组)和不需要重症监护组(2组)，比较两组患者的人口学特征、输血量、重症监护时间、产妇并发症和死亡率。结果本研究对2011年至2018年在某三级中心分娩的14032名新生儿进行了评估。在研究期间，342例患者被诊断为HELLP，其中32例(9.4%)在重症监护病房随访。重症监护病房的住院时间平均为8.1(7.2)天。在1组患者中，新鲜冷冻血浆、红细胞悬液、血浆分离和随机血小板输注的发生率明显更高。回归分析发现最有效的因素是红细胞悬液，输注红细胞悬液的患者在重症监护病房的住院时间明显延长。受者工作特征曲线显示输血红细胞曲线值下面积为70.6%。当红细胞悬液临界值为450 ml (95% CI: 365 ~ 681)时，敏感性为43.8%，特异性为91.6%。结论:我们认为，医生应该注意，产妇发病率和死亡率可能会随着HELLP综合征患者红细胞悬浮液输血需求的增加而增加。从发病率和死亡率来看，对血流动力学稳定的患者进行最小输血可能更适合于管理需要红细胞悬液输血的HELLP综合征患者。在这方面应采取预防和措施。

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Factors Affecting ICU Stay and Length of Stay in the ICU in Patients with HELLP Syndrome in a Tertiary Referral Hospital

Objective The study aimed to compare patients with HELLP syndrome who require intensive care and who do not require intensive care and evaluate the factors affecting the length of stay in the intensive care unit. Methods Patients were divided into two groups as follows: requiring intensive care (group 1) and not requiring intensive care (group 2). The data of both groups were compared in terms of demographic characteristics, transfusion amounts, length of stay in the intensive care unit, maternal complications, and mortality. Results 14032 births in a tertiary center between 2011 and 2018 were evaluated in this study. During the study period, 342 patients were diagnosed with HELLP, and 32 (9.4%) of these were followed up in the intensive care unit. The length of stay in the intensive care unit was determined as 8.1 (7.2) days on average. Fresh frozen plasma, erythrocyte suspension, apheresis, and random thrombocyte transfusion were observed to be significantly more in group 1 patients. In the regression analysis, the most effective factor was found to be erythrocyte suspension and the length of stay in the intensive care unit was significantly longer in patients who had erythrocyte suspension transfusion. The receiver operating characteristic curve showed that the area under the curve value for erythrocyte transfusion was 70.6%. When the cutoff value of erythrocyte suspension was 450 (95% CI: 365–681) ml, the sensitivity was 43.8% and the specificity was 91.6%. Conclusion We think that physicians should be careful that maternal morbidity and mortality may increase as the need for erythrocyte suspension transfusion increases in patients with HELLP syndrome. Minimum transfusion to hemodynamically stable patients can be more suitable in terms of morbidity and mortality in managing patients with HELLP syndrome requiring erythrocyte suspension transfusion. Precautions and measures should be taken in this regard.

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来源期刊

International Journal of Hypertension Medicine-Internal Medicine

CiteScore

4.00

自引率

5.30%

发文量

期刊介绍： International Journal of Hypertension is a peer-reviewed, Open Access journal that provides a forum for clinicians and basic scientists interested in blood pressure regulation and pathophysiology, as well as treatment and prevention of hypertension. The journal publishes original research articles, review articles, and clinical studies on the etiology and risk factors of hypertension, with a special focus on vascular biology, epidemiology, pediatric hypertension, and hypertensive nephropathy.