目的:尿酸(UA)水平升高与急性和慢性疾病有关,这可能会影响儿科住院患者的预后。然而,在住院儿童和青少年中,UA水平与住院时间(LOS)和死亡率之间的关系尚不清楚.因此,本研究的目的是评估住院儿童和青少年中血清UA水平与住院死亡率和长期LOS的相关性.
方法:进行了一项回顾性队列研究,涉及128名18岁以下的患者,2014年1月至2018年12月期间入住三级医院。在住院结果(出院或死亡)前3天平均评估UA水平。Logistic回归用于确定UA与延长的LOS(定义为住院超过30天)的相关性,而Cox回归多变量分析用于评估UA作为院内死亡率的预测因子.
结果:UA水平与LOS延长呈负相关。具体来说,UA水平每增加1毫克/分升,LOS延长的几率降低了31%(OR=0.69;95%CI:0.50-0.95).此外,UA水平升高的个体出现LOS延长的几率较低(OR=0.23;95%CI:0.08~0.66).然而,UA水平与住院死亡率无关(HR=1.63;95%CI:0.94-2.82)。
结论:在儿童和青少年中,血清UA与LOS呈负相关,但未观察到与院内死亡率相关.
OBJECTIVE: Elevated uric acid (UA) levels have been associated with acute and chronic diseases, which could affect the prognosis of pediatric
hospitalized patients. However, the association of UA levels with length of hospital stay (LOS) and mortality in
hospitalized children and adolescents remains unknown. Therefore, the aim of this study was to evaluate the association of serum UA levels with in-hospital mortality and prolonged LOS in
hospitalized children and adolescents.
METHODS: A retrospective cohort study was conducted, involving 128 patients under 18 years of age, admitted to a tertiary-care hospital between January 2014 and December 2018. UA levels were assessed with an average of 3 days before the in-hospital outcome (discharge or death). Logistic regression was used to determine the association of UA with prolonged LOS (defined as over 30 days of hospitalization), while Cox regression multivariate analysis was employed to assess UA as a predictor of in-hospital mortality.
RESULTS: UA levels showed an inverse association with prolonged LOS. Specifically, for every 1 mg/dL increase in UA level, the odds of experiencing prolonged LOS decreased by 31% (OR = 0.69; 95% CI: 0.50-0.95). Additionally, individuals with elevated UA levels had lower odds of prolonged LOS (OR = 0.23; 95% CI: 0.08-0.66). However, UA levels were not associated with in-hospital mortality (HR = 1.63; 95% CI: 0.94-2.82).
CONCLUSIONS: Serum UA was inversely associated with LOS among children and adolescents, but no association was observed with in-hospital mortality.