红细胞分布宽度是入住重症监护室的肺栓塞患者长期预后的独立预测因子  

Red blood cell distribution width is an independent predictor of long term outcomes in pulmonary embolism patients admitted to the inten-sive care unit

作　　者：吴晓飞 陆叶 WU Xiaofei;LU Ye(Emergency Department,Ninth People's Hospital of Suzhou,Suzhou Jiangsu 215200,China)

机构地区：[1]苏州市第九人民医院急诊重症,江苏苏州215200

出　　处：《中国急救复苏与灾害医学杂志》2022年第1期102-106,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的明确红细胞分布宽度(RDW)对危重肺栓塞患者(PE)的预后作用。方法所有患者数据均从MIM⁃IC-III数据库中提取。Cox比例风险模型用于确定RDW浓度和1年死亡率之间的关系。为了确定RDW的预测值,笔者进行了受试者操作曲线(ROC)分析。结果一共纳入864例肺栓塞患者。在这些患者中,571人幸存,293人死亡。单变量和多变量Cox回归分析显示,高RDW水平(≥15.14%)是1年死亡率的独立危险因素(单因素分析HR,1.578;95%CI(置信区间),1.206~2.065;P=0.009。多因素分析,HR,1.679;95%CI,1.317~2.141;P<0.001)。RDW 1年死亡率的曲线下面积(AUC)值为0.679(95%CI为0.641~0.716),敏感度为0.614,特异度为0.707,截止点为15.14%。当将RDW加入到sPESI中作为一个新预测指标时,其显示的AUC值为0.752。结论RDW浓度是入住重症监护室的肺栓塞患者1年死亡率的独立预测因子。Objective To investigate the prognostic role of red blood cell distribution width(RDW)in critically ill pa⁃tients with pulmonary embolism(PE).Methods The clinical data of 864 PE patients treated inBeth Israel Deaconess Medical Center(BIDMC)were extracted from the Mimic-Ⅲdatabase.Cox proportional hazards models were used to de⁃termine the relationship between RDW concentrations and 1-year mortality.Receiver operating characteristic(ROC)analysis was performed in order to determine the predictive value of RDW.Results A total of 864 PE patients were in⁃cluded in the study.Among these patients,571 survived and 293 died.Univariate and multivariate Cox regression anal⁃yses showed that a high-RDW level(≥15.14%)was an independent risk factor for mortality at one year(univariate analy⁃sis,HR,1.578;95%CI,1.206~2.065;P=0.009;multivariate analysis,HR,1.679;95%CI,1.317~2.141;P<0.001).The area under the curve(AUC)values of RDW for 1-year mortality was 0.679(95%CI,0.641~0.716),with a sensitivity of 0.614 and specificity of 0.707 for a cut-off point of 15.14%.When RDW was added to the simplified pulmonary embo⁃lism severity index(sPESI),the new variable showed a maximum AUC value of 0.752.Conclusion RDW concentratio⁃nis an independent predictors for 1-year mortality in pulmonary embolism patients admitted to ICU.

关 键 词：红细胞分布宽度 肺栓塞 1年死亡率 重症监护病房 

分 类 号：R331.141[医药卫生—人体生理学]