红细胞分布宽度与白蛋白比值对重症患者30d预后的预测价值  

Predictive Value of Red Blood Cell Distribution Width to Albumin Ratio for 30d Prognosis of Critically Ill Patients

作　　者：王小菊[1] 陈瑜[2] WANG Xiaoju;CHEN Yu(Neurosurgery Department,Xingguo County People's Hospital,Xingguo,Jiangxi 342400;General Department,Gannan Medical College the First Affiliated Hospital,Ganzhou,Jiangxi 341000)

机构地区：[1]兴国县人民医院神经外科,江西兴国342400 [2]赣南医学院第一附属医院全科,江西赣州341000

出　　处：《智慧健康》2023年第20期118-121,共4页Smart Healthcare

摘　　要：目的 探讨红细胞分布宽度与白蛋白比值(RAR)对重症患者30d预后的预测价值。方法 所有数据提取自重症监护医学信息数据库-Ⅲ(MIMIC-Ⅲ)。计算重症患者进入重症监护病房(ICU)第1天的RAR。根据30d转归情况将患者分为生存组及死亡组,受试者工作特征曲线(ROC)评价预测价值,Cox回归分析30d死亡的危险因素并绘制Kaplan-Meier生存曲线。结果 共11936例患者被纳入本研究。RAR预测ICU患者30d预后的ROC曲线下的面积为0.661,95%CI为0.649~0.674(P<0.001);根据最大约登指数计算得出最佳截断值为5.2。多因素Cox回归分析显示,RAR≥5.2是ICU患者30d死亡的独立危险因素(HR=1.37,P<0.001)。Kaplan-Meier生存曲线结果显示,高RAR组30d生存率高于低RAR组。结论 RAR是重症患者30d死亡的独立危险因素。Objective To explore predictive value of red blood cell distribution width to albumin ratio(RAR)for 30d prognosis of critically ill patients.Methods The paper extracted data from Intensive Care Medical Information Database-Ⅲ(MIMIC-Ⅲ),and calculated RAR of critically ill patients on first day of admission to intensive care unit(ICU),and divided them into survival and death groups according to 30d outcome.Predictive value was evaluated by receiver operating characteristic curve(ROC),risk factors for 30-day death were analyzed by Cox regression and Kaplan Meier survival curve was drawn.Results 11936 patients were included in study,area under receiver operating characteristic predicted by RAR for 30 day prognosis of ICU patients was 0.661,95%CI was 0.649~0.674,P<0.001.According to maximum Youden's J statistic,optimal cutoff value was 5.2.Multivariate Cox regression analysis showed RAR≥5.2 was an independent risk factor for 30-day mortality of ICU patients(HR=1.37,P<0.001).Kaplan Meier survival curve showed 30 day survival rate of high RAR group was higher than low RAR group.Conclusion RAR is an independent risk factor for 30-day mortality of critically ill patients.

关 键 词：红细胞分布宽度 白蛋白 重症病人 30d预后 

分 类 号：R459.7[医药卫生—急诊医学] R446.11[医药卫生—治疗学]