入院低钠血症对老年肠梗阻病人一年全因死亡的预测价值  

The predictive value of admission hyponatremia for one-year all-cause mortality in elderly patients with bowel obstruction

作　　者：刘飞 刘军军[2] 宋家玉 许海宴 印山河 王阳春 仝瑞祥 杨卫富 LIU Fei;LIU Junjun;SONG Jiayu;XU Haiyan;YIN Shanhe;WANG Yangchun;TONG Ruixiang;YANG Weifu(Department of General Surgery,Nanjing Meishan Hospital,Nanjing 210039,China)

机构地区：[1]南京梅山医院普外科,210039 [2]南京梅山医院医学心理科,210039 [3]南京梅山医院内分泌科,210039 [4]南京医科大学

出　　处：《临床外科杂志》2024年第10期1055-1058,共4页Journal of Clinical Surgery

基　　金：南京市医学科技发展基金项目(YKK20184、YKK21216、YKK22264)。

摘　　要：目的探讨入院时低钠血症对于老年肠梗阻病人出院后一年内全因死亡的预测价值。方法2017年1月~2020年12月我院普外科就诊的老年(年龄≥60岁)肠梗阻病人331例。以病人入院时血钠浓度分为两组:低钠血症组(Na<135 mmol/L)和非低钠血症组(Na≥135 mmol/L);以是否发生出院后一年内死亡分为死亡组和生存组。采用spss 25.0软件,应用独立样本t检验、χ^(2)检验、Kaplan-Meier法和多因素Cox回归分析观察老年肠梗阻病人入院低钠血症与出院后一年内全因死亡的相关性。结果共有331例病人完成随访,低钠血症发生率32.3%,一年内死亡56例(16.92%)。低钠血症组一年内死亡率为23.4%(25/107),大于非低钠血症组的13.8%(31/224),差异有统计学意义(P<0.05)。生存分析(Kaplan-Meier)结果显示,低钠血症组生存率低于非低钠血症组(Log-Rank P<0.05)。多因素Cox回归分析调整其他混杂因素后,低钠血症(HR=1.88,95%CI:1.07~3.29)是老年肠梗阻一年全因死亡的独立危险因素(P<0.05)。结论入院时低钠血症是老年肠梗阻病人出院后一年内全因死亡的独立危险因素。Objective To explore the correlation between hyponatremia at admission and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Methods The 331 cases of elderly patients with intestinal obstruction(aged≥60 years)who visited the General Surgery Department of Nanjing Meishan Hospital from January 2017 to December 2020 were selected as the research objects for retrospective cohort study analysis.According to the patient’s blood sodium level at admission,they are divided into two groups:the hyponatremia group(Na<135 mmol/L)and the non hyponatremia group(Na≥135 mmol/L).Divided into death group and survival group based on whether death occurred within one year after discharge.SPSS 25.0 software was used for statistical analysis.Independent sample t test,χ^(2) test,Kaplan Meier method,and multivariate Cox regression analysis were used to observe the correlation between admission hyponatremia and all-cause mortality within one year after discharge in elderly patients with intestinal obstruction.Results A total of 331 patients were enrolled.The incidence of hyponatremia was 32.3%,and 56 deaths occurred within one year,accounting for 16.92%.The one-year mortality rate in the hyponatremia group was 23.4%(25/107),which was higher than 13.8%(31/224)in the non hyponatremia group.The difference was statistically significant(P<0.05).The survival analysis(Kaplan Meier)results showed that the survival rate of the hyponatremia group was lower than that of the non hyponatremia group(Log Rank P<0.05).After adjusting for other confounding factors in multivariate Cox regression analysis,hyponatremia(HR=1.88,95%CI:1.07-3.29)was an independent risk factor for one-year allcause mortality in elderly patients with intestinal obstruction(P<0.05).Conclusion Hyponatremia at admission is an independent risk factor for all cause mortality in elderly patients with intestinal obstruction within one year after discharge.

关 键 词：低钠血症 一年全因死亡率 老年病人 肠梗阻 

分 类 号：R574.2[医药卫生—消化系统] R591.1[医药卫生—内科学]