强离子间隙与脓毒症患者预后的相关性分析

Correlation analysis of strong ion gap and prognosis of patients with sepsis

目的 探讨强离子间隙(SIG)与脓毒症患者ICU住院期间预后的相关性。方法 回顾性分析2008年至2019年美国重症监护数据库(MIMIC-IV)中8963例ICU收治的成人脓毒症患者的临床资料,根据住院期间患者的预后情况,分为存活组和死亡组。比较两组患者一般临床资料,分析SIG与脓毒症患者住院期间全因死亡风险以及临床结局的相关性。结果 两组患者年龄、序贯器官衰竭估计(SOFA)评分、急性生理学评分Ⅲ(APS Ⅲ)、合并慢性阻塞性肺病、肝硬化、急性心肌梗死及急性肾损伤的比例以及SIG等一般资料比较,差异有统计学意义(P<0.05)。SIG与脓毒症患者ICU住院期间全因死亡风险呈线性相关,回归分析高SIG(≥5.091 mmol/L)是患者住院期间全因死亡率高的独立危险因素(HR=1.227,95%CI:1.094~1.377,P<0.05)。结论 强离子间隙升高(≥5.091 mmol/L)是脓毒症患者ICU住院期间全因死亡率升高的独立危险因素。

Objective To explore the correlation between strong ion gap(SIG)and the prognosis of sepsis patients during ICU hospitalization,aiming to improve the outcomes of patients.Methods The clinical data of 8963 adult sepsis patients admitted to ICU in the American Intensive Care Database(MIMIC-IV)from 2008 to 2019 were retrospectively analyzed,and the study population were divided into the survival group and the death group based on the prognosis during hospitalization.The association between SIG and the risk of ICU all-cause mortality and the prognosis of patients with sepsis and determine the optimal cut-off value of SIG were analyzed.Results The difference between the general information such as age,sequential organ failure assessment(SOFA)score,acute physiology score Ⅲ(APS Ⅲ),SIG in the two groups were statistically significant(P<0.05).RCS showed that there was a linear trend relationship between SIG and the risk of ICU all-cause mortality in patients with sepsis.COX regression analysis showed that high SIG(≥5.091 mmol/L)was an independent risk factor for all-cause mortality during hospitalization(HR=1.227,95%CI:1.094~1.377,P<0.05).Conclusion Elevated strong ion gap value(≥5.091 mmol/L)is an independent risk factor for increased ICU all-cause mortality in patients with sepsis.