血清白蛋白、降钙素原联合红细胞分布宽度对重型颅脑损伤患者住院期间死亡风险的预测价值研究

Predictive Value of Serum Albumin and Procalcitonin Combined with Red Blood Cell Distribution Width for the Risk of In-hospital Mortality in Patients with Severe Traumatic Brain Injury

目的:探讨血清白蛋白(Alb)、降钙素原(PCT)联合红细胞分布宽度(RDW)对重型颅脑损伤(s TBI)患者住院期间死亡风险的预测价值。方法:选取2019年1月~2022年2月长沙市第一医院收治的120例s TBI患者,根据住院期间预后情况分为死亡组和存活组。收集s TBI患者临床资料并检测其血清Alb、PCT、RDW水平。采用多因素Logistic回归分析s TBI患者住院期间预后的影响因素,受试者工作特征(ROC)曲线分析血清Alb、PCT、RDW对s TBI患者住院期间死亡风险的预测价值。结果:120例s TBI患者住院期间死亡率为45.83%(55/120)。体温升高、糖尿病、瞳孔散大、基底池异常、中线移位≥5 mm、蛛网膜下腔出血和PCT、RDW升高为s TBI患者住院期间死亡的独立危险因素,Alb升高、格拉斯哥昏迷量表(GCS)评分增加为独立保护因素(P<0.05)。血清Alb、PCT、RDW联合预测s TBI患者住院期间死亡风险的曲线下面积大于Alb、PCT、RDW单独预测。结论:临床应重视s TBI患者住院期间预后的影响因素,并采取对应措施进行干预。血清Alb、PCT、RDW联合预测s TBI患者住院期间死亡风险的价值较高,可作为s TBI患者住院期间死亡风险的预警指标。

Objective:To investigate the predictive value of serum albumin(Alb),procalcitonin(PCT),and red blood cell distri-bution width(RDW)on the risk of in-hospital mortality in patients with severe traumatic brain injury(sTBI).Methods:120 patients with sTBI who were admitted to Changsha First Hospital from January 2019 to February 2022 were selected,and they were divided into death group and survival group according to the prognosis during hospitalization.Clinical data of patients with sTBI were collected and serum Alb,PCT and RDW levels were detected.Multivariate Logistic regression was used to analyze the influencing factors of the prognosis of patients with sTBI during hospitalization,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum Alb,PCT and RDW for the risk of death in patients with sTBI during hospitalization.Results:The mortality rate during hospital-ization in 120 patients with sTBI was 45.83%(55/120).Elevated body temperature,diabetes mellitus,dilated pupils,abnormal basal pool,midline shift≥5 mm,subarachnoid hemorrhage and elevated PCT and RDW were independent risk factors for death in patients with sTBI during hospitalization,and elevated Alb and increased Glasgow Coma Scale(GCS)score were independent protective factors(P<0.05).The area under curve of serum Alb,PCT and RDW combined predicted the risk of death in patients with sTBI during hospital-ization was greater than that of Alb,PCT and RDW alone.Conclusions:Clinical attention should be paid to the influencing factors of the prognosis of sTBI patients during hospitalization and corresponding measures should be taken to intervene.The combination of serum Alb,PCT and RDW has a high value in predicting the death risk of sTBI patients during hospitalization,and can be used as an early warning indicator of the death risk of sTBI patients during hospitalization.