■本研究旨在评估老年T2DM(2型糖尿病)脑梗死患者的SpO2(经皮氧饱和度)与死亡率的联系,并确定其最佳SpO2范围。
■在这次调查中,我们采用了全面的方法。最初,我们筛选了MIMIC-IV数据库,老年T2DM合并脑梗死的鉴别,利用特定的ICD-9和ICD-10代码。然后,我们利用有限的三次样条的力量来制作SpO2与1年死亡率之间相关性的视觉表示。为了加强我们的分析,我们利用了Cox多元回归,允许我们计算伴随95%置信区间(CI)的调整后风险比(HR)。此外,我们制作了累积死亡率曲线分析,通过进行严格的亚组分析来加强我们的研究,根据相关的协变量对我们的观察结果进行分层。
■在这项研究中,纳入448例老年T2DM合并脑梗死患者。出院后1年内,161例(35.94%)死亡。采用受限三次样条分析,入院ICUSpO2水平与1年死亡率之间存在显著的U型非线性关系(P值<0.05).进一步的分析表明,低和高SpO2水平都会增加死亡风险。Cox多元回归分析,调整潜在的混杂因素,证实了低(≤94.5%)和高SpO2水平(96.5-98.5%)与1年死亡风险升高的关联,特别是高SpO2水平(>98.5%)[HR=2.06,95%CI:1.29-3.29,P值=0.002]。累积死亡率曲线显示,在第365天,从高到低的累积死亡率以下SpO2亚组:正常水平(94.5%98.5%)。亚组分析表明SpO2和分组变量之间没有显著的相互作用,包括性,年龄,充血性心力衰竭,温度,和ICU住院时间(LOS-ICU;交互作用的P值>0.05)。
■寻求最佳平衡至关重要,因为只关注较低的SpO2限值或忽略高SpO2水平可能会导致死亡率增加。降低老年T2DM合并脑梗死患者的死亡风险,我们建议将SpO2水平维持在94.5-96.5%的范围内。
UNASSIGNED: This study aimed to evaluate the
SpO2 (transcutaneous oxygen saturation) -mortality link in elderly T2DM (diabetes mellitus type 2) patients with cerebral infarction and identify their optimal SpO2 range.
UNASSIGNED: In this investigation, we employed a comprehensive approach. Initially, we screened the MIMIC-IV database, identifying elderly T2DM patients with cerebral infarction, utilizing specific ICD-9 and ICD-10 codes. We then harnessed the power of restricted cubic splines to craft a visual representation of the correlation between SpO2 and 1-year mortality. To enhance our analysis, we harnessed Cox multivariate regression, allowing us to compute adjusted hazard ratios (HR) accompanied by 95% confidence intervals (CIs). Additionally, we crafted Cumulative Mortality Curve analyses, augmenting our study by engaging in rigorous subgroup analyses, stratifying our observations based on pertinent covariates.
UNASSIGNED: In this study, 448 elderly T2DM patients with cerebral infarction were included. Within 1-year post-discharge, 161 patients (35.94%) succumbed. Employing Restricted Cubic Spline analysis, a statistically significant U-shaped non-linear relationship between admission ICU SpO2 levels and 1-year mortality was observed (P-value < 0.05). Further analysis indicated that both low and high
SpO2 levels increased the mortality risk. Cox multivariate regression analysis, adjusting for potential confounding factors, confirmed the association of low (≤94.5%) and high SpO2 levels (96.5-98.5%) with elevated 1-year mortality risk, particularly notably high SpO2 levels (>98.5%) [HR = 2.06, 95% CI: 1.29-3.29, P-value = 0.002]. The cumulative mortality curves revealed the following SpO2 subgroups from high to low cumulative mortality at the 365th day: normal levels (94.5% <
SpO2 ≤ 96.5%), low levels (
SpO2 ≤ 94.5%), high levels (96.5% <
SpO2 ≤ 98.5%), and notably high levels (>98.5%). Subgroup analysis demonstrated no significant interaction between SpO2 and grouping variables, including Sex, Age, Congestive heart failure, Temperature, and ICU length of stay (LOS-ICU; P-values for interaction were >0.05).
UNASSIGNED: Striking an optimal balance is paramount, as fixating solely on lower SpO2 limits or neglecting high
SpO2 levels may contribute to increased mortality rates. To mitigate mortality risk in elderly T2DM patients with cerebral infarction, we recommend maintaining SpO2 levels within the range of 94.5-96.5%.