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Abstract：
BACKGROUND: The number of elderly patients who require surgery as their primary treatment has increased rapidly in recent years. Among 300 million people globally who underwent surgery every year, patients aged 65 years and over accounted for more than 30% of cases. Despite medical advances, older patients remain at higher risk of postoperative complications. Early diagnosis and effective prediction are essential requirements for preventing serious postoperative complications. In this study, we aim to provide new biomarker combinations to predict the incidence of postoperative intensive care unit (ICU) admissions > 24 h in elderly patients.
METHODS: This investigation was conducted as a nested case-control study, incorporating 413 participants aged ≥ 65 years who underwent non-cardiac, non-urological elective surgeries. These individuals underwent a 30-day postoperative follow-up. Before surgery, peripheral venous blood was collected for analyzing serum creatinine (Scr), procalcitonin (PCT), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP). The efficacy of these biomarkers in predicting postoperative complications was evaluated using receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) values.
RESULTS: Postoperatively, 10 patients (2.42%) required ICU admission. Regarding ICU admissions, the AUCs with 95% confidence intervals (CIs) for the biomarker combinations of Scr × PCT and Scr × CRP were 0.750 (0.655-0.845, P = 0.007) and 0.724 (0.567-0.882, P = 0.015), respectively. Furthermore, cardiovascular events were observed in 14 patients (3.39%). The AUC with a 95% CI for the combination of Scr × CRP in predicting cardiovascular events was 0.688 (0.560-0.817, P = 0.017).
CONCLUSIONS: The innovative combinations of biomarkers (Scr × PCT and Scr × CRP) demonstrated efficacy as predictors for postoperative ICU admissions in elderly patients. Additionally, the Scr × CRP also had a moderate predictive value for postoperative cardiovascular events.
BACKGROUND: China Clinical Trial Registry, ChiCTR1900026223.
METHODS: This investigation was conducted as a nested case-control study, incorporating 413 participants aged ≥ 65 years who underwent non-cardiac, non-urological elective surgeries. These individuals underwent a 30-day postoperative follow-up. Before surgery, peripheral venous blood was collected for analyzing serum creatinine (Scr), procalcitonin (PCT), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP). The efficacy of these biomarkers in predicting postoperative complications was evaluated using receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) values.
RESULTS: Postoperatively, 10 patients (2.42%) required ICU admission. Regarding ICU admissions, the AUCs with 95% confidence intervals (CIs) for the biomarker combinations of Scr × PCT and Scr × CRP were 0.750 (0.655-0.845, P = 0.007) and 0.724 (0.567-0.882, P = 0.015), respectively. Furthermore, cardiovascular events were observed in 14 patients (3.39%). The AUC with a 95% CI for the combination of Scr × CRP in predicting cardiovascular events was 0.688 (0.560-0.817, P = 0.017).
CONCLUSIONS: The innovative combinations of biomarkers (Scr × PCT and Scr × CRP) demonstrated efficacy as predictors for postoperative ICU admissions in elderly patients. Additionally, the Scr × CRP also had a moderate predictive value for postoperative cardiovascular events.
BACKGROUND: China Clinical Trial Registry, ChiCTR1900026223.
摘要：
背景：近年来，需要手术作为主要治疗的老年患者数量迅速增加。在全球每年接受手术的3亿人中，65岁及以上的患者占病例的30%以上。尽管医学上有进步,老年患者术后并发症的风险仍然较高.早期诊断和有效预测是预防严重术后并发症的必要条件。在这项研究中,我们的目标是提供新的生物标志物组合来预测老年患者术后重症监护病房(ICU)住院时间>24h的发生率.
方法：这项调查是作为巢式病例对照研究进行的，纳入413名年龄≥65岁接受非心脏手术的参与者，非泌尿外科选择性手术。这些人接受了30天的术后随访。手术前,收集外周静脉血用于分析血清肌酐（Scr），降钙素原(PCT),C反应蛋白(CRP),高敏CRP(hsCRP)。使用受试者工作特征（ROC）曲线分析和曲线下面积（AUC）值评估这些生物标志物在预测术后并发症中的功效。
结果：术后，10例(2.42%)需要入住ICU。关于ICU入院，Scr×PCT和Scr×CRP组合的具有95%置信区间(CI)的AUC分别为0.750(0.655-0.845,P=0.007)和0.724(0.567-0.882,P=0.015),分别。此外，14例患者(3.39%)发生心血管事件.Scr×CRP联合预测心血管事件的AUC(95%CI)为0.688(0.560～0.817,P=0.017)。
结论：生物标志物（Scr×PCT和Scr×CRP）的创新组合证明了作为老年患者术后ICU入住的预测因子的有效性。此外,Scr×CRP对术后心血管事件也有中等预测价值.
背景：中国临床试验注册中心，ChiCTR1900026223。
方法：这项调查是作为巢式病例对照研究进行的，纳入413名年龄≥65岁接受非心脏手术的参与者，非泌尿外科选择性手术。这些人接受了30天的术后随访。手术前,收集外周静脉血用于分析血清肌酐（Scr），降钙素原(PCT),C反应蛋白(CRP),高敏CRP(hsCRP)。使用受试者工作特征（ROC）曲线分析和曲线下面积（AUC）值评估这些生物标志物在预测术后并发症中的功效。
结果：术后，10例(2.42%)需要入住ICU。关于ICU入院，Scr×PCT和Scr×CRP组合的具有95%置信区间(CI)的AUC分别为0.750(0.655-0.845,P=0.007)和0.724(0.567-0.882,P=0.015),分别。此外，14例患者(3.39%)发生心血管事件.Scr×CRP联合预测心血管事件的AUC(95%CI)为0.688(0.560～0.817,P=0.017)。
结论：生物标志物（Scr×PCT和Scr×CRP）的创新组合证明了作为老年患者术后ICU入住的预测因子的有效性。此外,Scr×CRP对术后心血管事件也有中等预测价值.
背景：中国临床试验注册中心，ChiCTR1900026223。
