平均心率对老年败血症患者 30 天死亡率的影响:来自 MIMIC-IV 数据库的数据。

Qiang Zhou, Jianing Li, Yuxiu Miao, Na Li
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引用次数: 0

摘要

背景:败血症是一种危重病,死亡率很高。高龄是增加重症监护死亡率的一个因素:本研究旨在调查重症监护室(ICU)中患有败血症的老年患者的平均心率(MHR)与 30 天死亡率之间的关系:这项回顾性研究纳入了重症监护医学信息市场-IV(MIMIC-IV)中所有首次入住重症监护室的老年脓毒症患者(65 岁或以上)。根据多变量 Cox 回归模型、限制性立方样条和双片式 Cox 回归模型评估了入院 24 小时内 MHR 对 30 天死亡率的影响:结果:参与研究的总人数为 6598 人(平均心率为 83.8±14.3 bpm)。共有 1295 名(19.6%)患者在入住 ICU 后 30 天内死亡。入院24小时内的MHR与重症监护室老年脓毒症患者30天内的死亡率有关(J形关联),拐点在74 bpm左右,MHR在73至82 bpm时风险最小:在这项回顾性队列研究中,入住重症监护室的老年脓毒症患者的 MHR 与 30 天死亡率呈 "J "形关联,MHR 在 73 至 82 bpm 时风险最小。如果得到进一步证实,这种关联可为制定这些患者的心率治疗目标策略提供理论依据。
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Effect of mean heart rate on 30-day mortality in older patients with sepsis: Data from the MIMIC-IV database.

Background: Sepsis is a critical condition with a significant risk of mortality. Advanced age is one factor in increasing mortality in intensive care.

Objectives: The aim of this study is to investigate the association between mean heart rate (MHR) and 30-day mortality among older patients with sepsis in the intensive care unit (ICU).

Methods: All older patients (age 65 or older) with sepsis for first time in ICU admission in Medical Information Mart for Intensive Care-IV (MIMIC-IV) were included in this retrospective study. The effect of MHR within 24 h of ICU admission on 30-day mortality was assessed according to multivariable Cox regression models, restricted cubic splines and two-piecewise Cox regression models.

Results: The total number of participants was 6598 (mean heart rate, 83.8 ± 14.3 bpm). A total of 1295 (19.6%) patients died within 30 days after ICU admission. MHR within 24 h of admission was associated with 30-day mortality (J-shaped association) in older patients with sepsis in the ICU, with an inflection point at about 74 bpm and a minimal risk observed at 73 to 82 bpm of MHR.

Conclusions: In this retrospective cohort study, there was a J-shaped association between MHR and 30-day mortality in older patients with sepsis admitted to the ICU and a minimal risk observed at 73 to 82 bpm of MHR. If further confirmed, this association may provide a theoretical basis for formulating the target strategy of heart rate therapy for these patients.

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