■在诊断为静脉血栓栓塞症(VTE)的重症监护病房(ICU)患者中,血尿素氮与肌酐比值(BCR)与院内死亡风险之间的关系仍不清楚。本研究旨在评估重症VTE患者入住ICU时的BCR与院内死亡率之间的关系。
这项回顾性队列研究纳入了重症监护医学信息集市(MIMIC-IV)数据库中诊断为VTE的患者。主要终点是住院死亡率。进行单因素和多因素logistic回归分析以评估BCR的预后意义。利用受试者工作特征(ROC)曲线分析来确定BCR的最佳截止值。此外,采用Kaplan-Meier曲线进行生存分析.
■共纳入2,560名患者,平均年龄为64.5岁,55.5%为男性。总的来说,住院死亡率为14.6%.BCR预测重症VTE患者院内死亡率的最佳临界值为26.84。与低BCR组相比,高BCR组患者的住院死亡率明显更高(22.6%vs.12.2%,P<0.001)。多变量Logistic回归分析结果表明,即使在考虑了潜在的混杂因素之后,与BCR水平较低的患者相比,BCR升高的患者的院内死亡率显着增加(所有P<0.05),不管使用的模型。高BCR组患者的住院死亡率比低BCR组患者高77.77%[风险比(HR):1.7777;95%CI:1.4016-2.2547]。
■在诊断为VTE的危重患者中,BCR水平升高与院内死亡风险增加独立相关。鉴于其广泛的可用性和易于测量,BCR可能是VTE患者风险分层和预后预测的有价值的工具。
UNASSIGNED: The relationship between the blood urea nitrogen to creatinine ratio (BCR) and the risk of in-hospital mortality among intensive care unit (ICU) patients diagnosed with venous thromboembolism (VTE) remains unclear. This
study aimed to assess the relationship between BCR upon admission to the ICU and in-hospital mortality in critically ill patients with VTE.
UNASSIGNED: This retrospective cohort
study included patients diagnosed with VTE from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The primary endpoint was in-hospital mortality. Univariate and multivariate logistic regression analyses were conducted to evaluate the prognostic significance of the BCR. Receiver operating characteristic (ROC) curve analysis was utilized to determine the optimal cut-off value of BCR. Additionally, survival analysis using a Kaplan-Meier curve was performed.
UNASSIGNED: A total of 2,560 patients were included, with a median age of 64.5 years, and 55.5% were male. Overall, the in-hospital mortality rate was 14.6%. The optimal cut-off value of the BCR for predicting in-hospital mortality in critically ill VTE patients was 26.84. The rate of in-hospital mortality among patients categorized in the high BCR group was significantly higher compared to those in the low BCR group (22.6% vs. 12.2%, P < 0.001). The multivariable logistic regression analysis results indicated that, even after accounting for potential confounding factors, patients with elevated BCR demonstrated a notably increased in-hospital mortality rate compared to those with lower BCR levels (all P < 0.05), regardless of the model used. Patients in the high BCR group exhibited a 77.77% higher risk of in-hospital mortality than those in the low BCR group [hazard ratio (HR): 1.7777; 95% CI: 1.4016-2.2547].
UNASSIGNED: An elevated BCR level was independently linked with an increased risk of in-hospital mortality among critically ill patients diagnosed with VTE. Given its widespread availability and ease of measurement, BCR could be a valuable tool for risk stratification and prognostic prediction in VTE patients.