初始血清白蛋白水平对成人吸入性肺炎住院死亡的预测价值  

Predictive value of initial serum albumin levels for in-hospital mortality in adults with aspiration pneumonia

作　　者：蔡累 李毅 秦逸辉 余研 冯茜 钟素 徐明娜 许细萍 翁友飞 梁萌 CAI Lei;LI Yi;QIN Yihui;YU Yan;FENG Qian;ZHONG Su;XU Mingna;XU Xiping;WENG Youfei;LIANG Meng(The 73rd Army Group Hospital of the PLA Army,Xiamen,Fujian 361001,China)

机构地区：[1]中国人民解放军陆军第七十三集团军医院,厦门361001

出　　处：《福建医药杂志》2024年第6期10-14,共5页Fujian Medical Journal

基　　金：福建卫健委科技计划项目(20210N0100129)。

摘　　要：目的探讨血清白蛋白对成人吸入性肺炎住院死亡的预测价值。方法采用回顾性队列研究方法对中国人民解放军陆军第七十三集团军医院近4年成人吸入性肺炎住院患者的数据进行分析,评估急诊初始血清白蛋白水平对吸入性肺炎患者住院死亡率的影响,分析其与住院死亡率的相关性。结果入选患者248例,其中死亡51例(20.6%)。所有患者平均血清白蛋白水平为(3.4±0.7)g/dL,非存活组明显低于存活组[(3.0±0.6)g/dL对比(3.5±0.6)g/dL]。在多变量logistic回归模型中,白蛋白水平与住院死亡率呈负相关。血清白蛋白预测住院死亡的受试者工作特征曲线下面积(AUROC)为0.72,Youden指数为35.10%,敏感度、特异度、阳性预测值、阴性预测值、阳性和阴性似然比分别为68.6%、66.5%、34.7%、89.1%、2.05和0.47。白蛋白水平为4.0 g/dL时灵敏度最高(98.0%),白蛋白水平为2.5 g/dL时特异度最高(94.9%)。结论成人吸入性肺炎住院患者中,初始血清白蛋白水平与住院死亡率负相关,其对临床医师预测成人吸入性肺炎住院死亡具有重要意义,也为判断此病的预后转归提供一定的参考。Objective To explore the predictive value of serum albumin for in-hospital mortality in adults with aspiration pneumonia.Methods The data of adult inhalation pneumonia inpatients in the 73rd Army Group Hospital of the PLA Army over the past four years were collected using a retrospective cohort study method,the impact of initial serum albumin levels in mergency departments on in-hospital mortality in patients with aspiration pneumonia was assessed,and its correlation with in-hospital mortality was analyze.Results A total of 248 patients were enrolled,of whom,51 patients(20.6%)died.The mean serum albumin level was(3.4±0.7)g/dL.The serum albumin level was significantly lower in the non-survivor group than that in the survivor group[(3.0±0.6)g/dL vs.(3.5±0.6)g/dL].In the multivariable logistic regression model,albumin was associated with in-hospital mortality significantly.The area under the receiver operating characteristics(AUROC)for predicting in-hospital mortality using serum albumin was 0.72[95%CI(0.64,0.80)].The Youden index was 35.10%,and the corresponding sensitivity,specificity,positive predictive value,negative predictive value,positive and negative likelihood ratio was 68.6%,66.5%,34.7%,89.1%,2.05 and 0.47,respectively.Highest sensitivity(98.0%)was shown at albumin level of 4.0 g/dL and highest specificity(94.9%)was shown at albumin level of 2.5 g/dL.Conclusion Initial serum albumin level is negatively correlated with in-hospital mortality among adult patients hospitalized with aspiration pneumonia,which is of great significance for clinical physicians to predict in-hospital mortality of adult aspiration pneumonia and provide a certain reference to judge the prognosis of this disease.

关 键 词：白蛋白 死亡率 吸入性肺炎 

分 类 号：R446[医药卫生—诊断学]