转甲状腺素浓度低与老年住院患者的不良预后有关。

IF 3.4 2区 医学 Q2 GERIATRICS & GERONTOLOGY BMC Geriatrics Pub Date : 2024-10-30 DOI:10.1186/s12877-024-05467-3
Ting Wang, Zhi-Kai Yang, Yu-Hao Wan, Ke Chai, Ying-Ying Li, Yao Luo, Min Zeng, Ning Sun, Song Zou, Hua Wang
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引用次数: 0

摘要

背景:研究老年住院患者转甲状腺素(前白蛋白)浓度低与死亡率或因各种原因再次入院之间的关系:研究老年住院患者转甲状腺素(前白蛋白)低浓度与死亡率或因各种原因再入院之间的关系:本分析基于 2018 年 9 月至 2019 年 4 月在北京三家三级转诊医院的十个病房进行的前瞻性队列研究。入组 65 岁及以上患者,收集患者的临床数据、实验室检查结果和辅助检查结果。对患者进行了为期三年的随访。根据转甲状腺素浓度的第5百分位数和第95百分位数,将患者分为三组。研究了转甲状腺素浓度与老年住院患者预后之间的相关性。研究的主要结果是三年内因各种原因死亡或再次入院:在参与研究的 636 人中,335 人(52.7%)为男性,中位年龄为 74.7 岁(四分位距[IQR]:69.3-80.1)。在中位 1099.0 天(IQR:1,016.3-1,135.0)的随访期间,363 人(57.0%)经历了全因死亡或再入院事件。与转甲状腺素浓度介于第 5 和第 95 百分位数之间的患者相比,转甲状腺素浓度处于或低于第 5 百分位数的患者发生全因死亡或再入院的风险显著增加(危险比 [HR]:2.25;95% 置信区间 [CI]:1.55-3.26)。即使调整了潜在的混杂因素,转甲状腺素浓度低仍然是老年住院患者预后不良的独立风险因素(HR:1.84;95% CI:1.03-3.28)。由于女性的转甲状腺素基线水平一直低于男性,因此我们进行了性别分析。我们发现,转甲状腺素浓度低是老年男性住院患者不良预后的一个独立风险因素(HR:2.99;95% CI:1.35-6.62),但在女性患者中并非如此:结论:转甲状腺素浓度低与老年住院患者全因死亡率或再入院率升高有关,尤其是男性患者。
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Low transthyretin concentration linked to adverse prognosis in elderly inpatients.

Background: To investigate the association between low transthyretin (prealbumin) concentration and mortality or readmission for all causes in elderly inpatients.

Methods: This analysis is based on a prospective cohort study conducted from September 2018 to April 2019 in ten wards of three tertiary referral hospitals in Beijing. Patients aged 65 years or older were enrolled, and their clinical data, laboratory test results, and auxiliary test results for patients were collected. A three-year follow-up was conducted with patients. Based on the 5th and 95th percentiles of transthyretin concentration, patients were split into three groups. The correlation between transthyretin concentration and the outcome of elderly hospitalized patients was investigated. The primary outcome of the research was death or readmission from all causes within three years.

Results: Among the 636 individuals in the study, 335 (52.7%) were males, with a median age of 74.7 years (interquartile range [IQR]: 69.3-80.1). During a median follow-up period of 1,099.0 days (IQR: 1,016.3-1,135.0), 363 individuals (57.0%) experienced all-cause mortality or readmission events. Patients with transthyretin concentrations at or below the 5th percentile had a significantly increased risk of all-cause mortality or readmission compared to those with concentrations between the 5th and 95th percentiles (hazard ratio [HR]: 2.25; 95% confidence interval [CI]: 1.55-3.26). Even after adjusting for potential confounders, low transthyretin concentration remained an independent risk factor for poor prognosis in elderly inpatients (HR: 1.84; 95% CI: 1.03-3.28). Since women have consistently lower baseline transthyretin levels than men, we performed gender-specific analysis. We found that low transthyretin concentration is an independent risk factor for adverse prognosis in elderly male inpatients (HR: 2.99; 95% CI: 1.35-6.62) but not in females.

Conclusions: Low transthyretin concentrations are associated with increased all-cause mortality or readmission in elderly inpatients, particularly among male patients.

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来源期刊
BMC Geriatrics
BMC Geriatrics GERIATRICS & GERONTOLOGY-
CiteScore
5.70
自引率
7.30%
发文量
873
审稿时长
20 weeks
期刊介绍: BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.
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