重症监护室脑梗死患者血清钙与院内死亡率的关系:一项队列研究。

IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY Frontiers in Neurology Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.3389/fneur.2024.1428868
Kaiwu Meng, Xiaoyang Lei, Dian He
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引用次数: 0

摘要

背景:血清钙水平与脑梗死预后之间的关系仍存在争议:目的:本研究旨在探讨入住重症监护室(ICU)的缺血性脑卒中重症患者血清钙水平与院内死亡率之间的相关性:方法: 使用 MIMIC-IV 数据库的数据进行了一项回顾性队列研究。收集了所有参与者的人口统计学和临床数据,包括性别、年龄、高血压、糖尿病、心肌梗死、心力衰竭、慢性阻塞性肺病、血红蛋白、钾、钠、阴离子间隙、血小板、白细胞、血糖、肌酐、格拉斯哥昏迷评分(GCS)、IV-tPA 给药(rt-PA)和机械血栓切除术(MT)。结果指标为院内死亡。采用多变量调整逻辑回归分析、曲线拟合、交互作用分析和阈值效应分析来评估ICU脑梗死患者血清钙水平与院内死亡率之间的关系:共纳入 2,680 名脑梗塞重症患者,平均血清钙水平为 8.6 ± 0.8 mg/dL。院内总死亡率为 19.5%,其中第 1 组(血清钙< 8.0 mg/dL)死亡率为 27.7%,第 2 组(血清钙 8-9 mg/dL)死亡率为 19.8%,第 3 组(血清钙≥ 9 mg/dL)死亡率为 13.9%。血清钙水平与院内死亡率之间存在非线性的 S 型关系。研究发现,血清钙水平在7.70-9.50 mg/dL范围内与ICU脑梗死患者院内死亡率增加有独立关联。在亚组分析中未发现明显的交互作用,敏感性分析结果保持稳定:结论:血清钙水平与重症监护室脑梗死重症患者的院内死亡率密切相关。在 7.70-9.50 mg/dL 的范围内,血清钙水平较低会增加这些患者的院内死亡风险,这强调了 ICU 医生密切监测的重要性。
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Association between serum calcium and in-hospital mortality in intensive care unit patients with cerebral infarction: a cohort study.

Background: The relationship between serum calcium levels and the prognosis of cerebral infarction remains controversial.

Purpose: This study aims to investigate the correlation between serum calcium levels and in-hospital mortality in critically ill patients with ischemic stroke admitted to the intensive care unit (ICU).

Methods: A retrospective cohort study was conducted using data from the MIMIC-IV database. Demographic and clinical data of all participants were collected including gender, age, hypertension, diabetes, myocardial infarction, heart failure, chronic obstructive pulmonary disease, hemoglobin, potassium, sodium, anion gap, platelets, white blood cells, glucose, creatinine, Glasgow coma score (GCS), IV-tPA administration (rt-PA), and mechanical thrombectomy (MT). The outcome measure was in-hospital death. Multivariable-adjusted logistic regression analysis, curve fitting, interaction analysis, and threshold effect analysis were employed to evaluate the relationship between serum calcium levels and in-hospital mortality among ICU patients with cerebral infarction.

Results: A total of 2,680 critically ill patients with cerebral infarction were enrolled, with a mean serum calcium level of 8.6 ± 0.8 mg/dL. The overall in-hospital mortality rate was 19.5%, where Group 1 (serum calcium < 8.0 mg/dL) had a mortality rate of 27.7%, Group 2 (serum calcium 8-9 mg/dL) had a rate of 19.8%, and Group 3 (serum calcium ≥ 9 mg/dL) had a rate of 13.9%. There was a non-linear, S-shaped relationship between serum calcium levels and in-hospital mortality. Serum calcium levels within the range of 7.70-9.50 mg/dL were found to be independently associated with increased in-hospital mortality in ICU patients with cerebral infarction. No significant interactions were detected in subgroup analyses, and the results of sensitivity analyses remained stable.

Conclusion: Serum calcium levels are independently associated with in-hospital mortality in critically ill patients with cerebral infarction in the ICU setting. Within the range of 7.70-9.50 mg/dL, lower serum calcium levels increase the risk of in-hospital death among these patients, emphasizing the importance of close monitoring by ICU physicians.

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来源期刊
Frontiers in Neurology
Frontiers in Neurology CLINICAL NEUROLOGYNEUROSCIENCES -NEUROSCIENCES
CiteScore
4.90
自引率
8.80%
发文量
2792
审稿时长
14 weeks
期刊介绍: The section Stroke aims to quickly and accurately publish important experimental, translational and clinical studies, and reviews that contribute to the knowledge of stroke, its causes, manifestations, diagnosis, and management.
期刊最新文献
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