文章摘要
刘先.NLR用于急诊疑似感染伴qSOFA=1的预后评估[J].安徽医药,待发表.
NLR用于急诊疑似感染伴qSOFA=1的预后评估
投稿时间:2024-05-08  录用日期:2024-06-20
DOI:
中文关键词: NLR can be used to evaluate the prognosis of suspected infection with qSOFA=1 in the emergency department
英文关键词: 
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作者单位地址
刘先* 南充市中医医院 四川省南充市顺庆区金鱼岭正街235号
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中文摘要:
      目的 探讨NLR(中性粒细胞与淋巴细胞的比值)用于急诊疑似感染伴qSOFA(快速序贯器官衰竭评估)=1的预后评估。方法 从MIMIC-Ⅳ数据库纳入急诊疑似感染伴qSOFA=1的患者,分为A组(意识形态改变)、B组(收缩压≤100mmHg)、C组(呼吸频率≥22次/min),比较高NLR与低NLR之间的不良预后的风险差异。主要不良预后为28d死亡,次要不良预后为72h接受重症技术支持,包括使用有创呼吸机、使用血管升压药及RRT(肾脏替代治疗)。结果 Logistic回归分析,B组,NLR是28d死亡的独立影响因素(OR=1.023,P<0.001);A组、C组,NLR非28d死亡的独立影响因素(P>0.05)。B组,NLR的均值为8.0(4.0-15.0)。Cox比例风险回归分析,B组,NLR≥15的死亡风险高于NLR<15者(HR=1.685,P=0.015);NLR≥4与NLR<4之间死亡风险差异无统计学意义(P>0.05)。B组,在院时间≥72h者,NLR≥15的72h接受重症技术支持的风险高于NLR<15者(使用呼吸机,HR=1.820,P=0.005;使用升压药,HR=1.912,P<0.001;RRT,HR=2.380,P=0.013)。结论 NLR可能适用于急诊疑似感染伴qSOFA=1(收缩压≤100mmHg)的预后评估。
英文摘要:
      Objective To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in patients with suspected infection and qSOFA (quick sequential organ failure assessment) =1 in emergency department. Methods Patients with suspected infection and qSOFA=1 in the emergency department were enrolled from MIMIC-Ⅳ database and divided into group A (ideological change), group B (systolic blood pressure ≤100 mmHg), and group C (respiratory rate ≥22 times /min). The risk of poor prognosis between high NLR and low NLR was compared. Main poor prognosis for 28 d death, secondary poor prognosis for 72 h in intensive technical support, including the use of the breathing machine, and using vessel vasopressors and RRT (renal replacement therapy). Results Logistic regression analysis, group B, NLR is 28 d of death the independent factors (OR = 1.023, P < 0.001); Group A and group C, NLR of 28 d death independent factors (P > 0.05). Group B, NLR average of 8.0 (4.0 15.0). Cox proportional hazards regression analysis showed that in group B, the risk of death in NLR≥15 group was higher than that in NLR < 15 group (HR=1.685, P=0.015). NLR acuity 4 and NLR < 4 death risk difference between no statistical significance (P > 0.05). In group B, for patients with hospitalization time ≥72 hours and NLR≥15, the risk of receiving critical technical support at 72 hours was higher than that of NLR < 15 (ventilator, HR=1.820, P=0.005; Vasopressor use, HR=1.912, P < 0.001; RRT, HR=2.380, P=0.013). Conclusions NLR may apply to emergency suspected infection with qSOFA = 1 (systolic blood pressure, 100 mmHg) or less) prognostic assessment.
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