ICU住院期间平均血清白蛋白水平和患者预后的相关性分析——一项多中心回顾性队列研究  

Association between mean serum albumin levels and the mortality during ICU hospitalization:a multicenter retrospective cohort study

作　　者：张静静[1] 金旭婷 李若寒 李佳媚[1] 高雅[1] 王小闯[1] 王岗[1] Zhang Jing-jing;Jin Xu-ting;Li Ruo-han;Li Jia-mei;Gao Ya;Wang Xiao-chuang;Wang Gang(Department of Critical Care Medicine,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)

机构地区：[1]西安交通大学第二附属医院重症医学科,陕西西安710004

出　　处：《中国急救医学》2022年第6期476-480,共5页Chinese Journal of Critical Care Medicine

基　　金：陕西省高层次人才特殊支持计划;西安交通大学第二附属医院院人才培养专项科研基金[RC(XM)202011]。

摘　　要：目的探讨成年患者ICU住院期间平均血清白蛋白水平对死亡的影响。方法本研究利用eICU合作研究数据库(eICU-CRD),采用多中心回顾性队列研究,纳入单次入院首次入ICU并且至少有2次血清白蛋白记录的成年患者,计算患者的平均血清白蛋白水平。按照ICU住院期间监测的平均血清白蛋白水平的三分位数将患者分为三组:低白蛋白组(<25 g/L)、中白蛋白组(25~30 g/L)和高白蛋白组(≥30 g/L),采用Logistic回归分析,并控制相关混杂因素,研究平均血清白蛋白水平和患者预后的相关性。结果本研究共纳入ICU患者20703例,低白蛋白组发生ICU死亡风险是高白蛋白组的1.368倍(95%CI 1.203~1.555),而中白蛋白组发生ICU死亡风险是高白蛋白组的1.147倍(95%CI 1.001~1.315);此外,低白蛋白组发生医院死亡风险是高白蛋白组的1.627倍(95%CI 1.458~1.816),而中白蛋白组发生医院死亡风险是高白蛋白组的1.182倍(95%CI 1.052~1.329)。结论在成年ICU患者中,平均血清白蛋白水平是其发生ICU死亡和医院死亡的危险因素。Objective To investigate the association between mean serum albumin level during ICU hospitalization and the mortality among adult ICU patients.Methods This was a multicenter and retrospective cohort study with data extracted from the eICU Collaborative Research Database.Patients with at least two serum albumin measurements conducted at the first admission to ICU were included in the study,the average serum albumin level of patients was calculated.According to the tertiles of calculated mean serum albumin level during ICU hospitalization,patients was divided into three groups:low albumin group(<25 g/L),medium albumin group(25-30 g/L),and high albumin group(≥30 g/L).Logistic regression analysis was performed to evaluate the relationship between mean albumin level and mortality.Results A total of 20703 ICU patients were included in this study.Taking the patients with high albumin level as reference,the patients with low albumin level during ICU hospitalization were associated with higher hospital mortality[odds ratio(OR)1.627,95%confidence interval(CI)1.458-1.816]and ICU mortality(OR 1.368,95%CI 1.203-1.555)after multivariable adjustment,the patients with medium albumin level were also associated with higher hospital mortality(OR 1.182,95%CI 1.052-1.329)and ICU mortality(OR 1.147,95%CI 1.001-1.315)after multivariable adjustment.Conclusions The mean serum albumin level is a risk factor for ICU mortality and hospital mortality in adult ICU patients.

关 键 词：重症监护室 平均白蛋白水平 ICU病死率 医院病死率 

分 类 号：R459.7[医药卫生—急诊医学]