RDW和前BNP预测老年急性失代偿性心力衰竭急诊患者的短期死亡率

IF 0.4 Q4 EMERGENCY MEDICINE Emergency Care Journal Pub Date : 2022-12-20 DOI:10.4081/ecj.2022.10747
S. Özdemir, A. Özkan
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引用次数: 1

摘要

揭示红细胞分布宽度(RDW)预测急诊室老年急性心力衰竭患者短期死亡率的能力,并将其结果与促B型利钠肽(促BNP)进行比较。这项前瞻性队列研究旨在评估2021年8月15日至2021年11月15日期间急诊科入院患者的数据。研究人群招募了65岁及以上的志愿者,他们出现了急性心力衰竭的体征和症状。记录了人口统计学、生命参数和实验室参数。共有424名患者被纳入研究。研究队列的30天死亡率为14.4%。老年、活动性恶性肿瘤、RDW、C反应蛋白、血尿素氮和前BNP是短期死亡率的早期独立预测因素。pro-BNP是比RDW更好的预测因子,曲线下面积值更大(0.841对0.752,p=0.045,DeLong等同性检验)。所创建的多变量回归模型能够高精度地检测短期死亡率的风险(曲线下面积:0.943,准确度:0.936,敏感性:98.1,特异性:67.2,p<0.001)。在急诊科就诊的老年急性失代偿性心力衰竭患者中,死亡率组的初始RDW和前BNP显著较高,发现前BNP比RDW更能预测死亡率。RDW是一种很有前途的血液学标志物,有助于预测该患者群体的短期死亡率。
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RDW and pro-BNP in predicting short-term mortality in geriatric patients presenting to the emergency department with acute decompensated heart failure
To reveal the ability of Red cell Distribution Width (RDW) to predict short-term mortality in geriatric patients presenting to the emergency department with acute heart failure and compare the results with pro B-type Natriuretic Peptide (pro-BNP). This prospective cohort study was conducted to evaluate the data of patients admitted to the emergency department between August 15th, 2021, and November 15th, 2021. The study population enrolled volunteers aged 65 years and over, who presented with acute heart failure signs and symptoms. Demographics, vital parameters, and laboratory parameters were noted. A total of 424 patients were included in the study. The 30 day-mortality rate of the study cohort was 14.4%. Older age, active malignancy, RDW, C-reactive protein, blood urea nitrogen, and pro-BNP were early independent predictors of short-term mortality. pro-BNP was a better predictor than RDW with a greater area under the curve value (0.841 versus 0.752, p=0.045, DeLong equality test). The created multivariate regression model was able to detect the risk of shortterm mortality with high accuracy (area under the curve: 0.943, accuracy: 0.936, sensitivity: 98.1, specificity: 67.2, p<0.001). Initial RDW and pro-BNP were significantly higher in the mortality group among the geriatric patients with acute decompensated heart failure presenting to the emergency department, and pro- BNP was found to be a better predictor of mortality than RDW. RDW presents as a promising hematological marker that aids in the prognosticating short-term mortality in this patient population.
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来源期刊
Emergency Care Journal
Emergency Care Journal EMERGENCY MEDICINE-
CiteScore
0.10
自引率
60.00%
发文量
29
审稿时长
10 weeks
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