血清 copeptin、乳酸和休克指数可预测休克急性中毒患者的发病率和死亡率。

IF 2.2 4区 医学 Q3 TOXICOLOGY Toxicology Research Pub Date : 2024-04-04 eCollection Date: 2024-04-01 DOI:10.1093/toxres/tfae053
Walaa G Abdelhamid, Sarah A Elmorsy, Ahmed Muhammed, Olfat E Mostafa, Sara Saeed
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引用次数: 0

摘要

背景:中毒引起的休克是一种严重的医疗急症,死亡率很高。住院的中毒者会出现多种不良心血管事件,并可能发展为心脏骤停。本研究旨在比较中毒休克患者的入院休克指数和血浆 copeptin 水平对预后的作用,并评估它们与患者最初特征和预后的关系:我们对急性中毒的成人患者进行了一项前瞻性研究:结果:共有 41 名患者参与了研究。所有患者的平均年龄为(27.05 ± 10.99)岁,大多数患者为女性(n = 27,66%)。农药是最常见的中毒类型(18 人,占 44%),其次是心血管药物(12 人,占 29.3%)。11名(26.8%)患者在住院期间死亡。最初的血清 copeptin 水平和休克指数可以预测器官功能障碍,以序贯器官评估评分(SOFA)为指标,曲线下面积(AUC)分别为 0.862 和 0.755。初始血清 copeptin 和乳酸水平、SOFA 评分以及它们的组合可以很好地区分存活者和非存活者,AUC 分别为 0.944、0.885、0.959 和 0.994:我们得出结论:休克指数、血清乳酸水平和 SOFA 评分有助于对中毒性休克危重症患者进行风险分层和预测预后。在预测研究对象的死亡率方面,谷丙肽优于休克指数。然而,SOFA 评分、血清 copeptin 水平和血清乳酸水平的组合可对这些患者的总体临床结果做出更主要的预测。
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Serum copeptin, lactate, and shock index as predictors of morbidity and mortality in shocked acutely poisoned patients.

Background: Poisoning-induced shock is a serious medical emergency with a high mortality rate. Hospitalized poisoned individuals experience multiple adverse cardiovascular events that could progress to cardiac arrest. This study was designed to compare the prognostic role of the admission shock index and plasma copeptin level in shocked poisoned patients and to evaluate their associations with initial patients' characteristics and outcomes.

Methods: We conducted a prospective study on acutely poisoned adult patients.

Results: A total of 41 patients were enrolled in the study. The mean age of all patients was 27.05 ± 10.99 years and most of the patients were females (n = 27, 66%). Pesticides were the most common type of poisoning (n = 18, 44%), followed by cardiovascular drugs (n = 12, 29.3%). Eleven (26.8%) patients died during the hospital stay length. The initial serum copeptin level and shock index could predict organ dysfunction indexed by sequential organ assessment score (SOFA) with area under the curve (AUCs) of 0.862 and 0.755, respectively. Initial serum copeptin and lactate levels, SOFA score, and their combination can strongly differentiate between survivors and non-survivors with an AUC of 0.944, 0.885, and 0.959, and 0.994, respectively.

Conclusion: We concluded that the shock index, serum lactate level, and SOFA score may help in risk stratifying patients and predicting outcomes in critically ill patients with poisoning-induced shock. Copeptin is superior to the shock index in predicting mortality among the studied patients. However, a combination of SOFA score, serum copeptin level, and serum lactate level can develop a more predominant prediction for overall clinical outcomes in these patients.

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来源期刊
Toxicology Research
Toxicology Research TOXICOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
82
期刊介绍: A multi-disciplinary journal covering the best research in both fundamental and applied aspects of toxicology
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