Angiogenic factors as promising therapeutic targets in sepsis: where are we now?
Angiogenic factors as promising therapeutic targets in sepsis: where are we now?
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DOI：
10.1097/ccm.0000000000000666
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发表时间：
2015
影响因子：
8.8
通讯作者：
Ru-yuan Zhang;Lei Li;Hong-ping Qu;Yaoqing Tang
中科院分区：
文献类型：
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作者：
Ru-yuan Zhang;Lei Li;Hong-ping Qu;Yaoqing Tang
重症监护医学www.ccmjournal.org e31对1，404名受试者的初步分析（左列）（4），所有具有两次前驱体重记录的患者按BMI类别调整的1年死亡率概率（中列），以及前两次调查之间体重变化0%时按BMI类别调整的患者死亡率（右列）。我们的结果与我们的初步分析一致，与原始报告没有统计学差异。BMI类别越大，死亡率越低，体重轨迹稳定的患者（右列）以及体重轨迹下降和上升的患者（数据未显示）。总体而言，我们得出结论，在考虑体重轨迹后，BMI与严重脓毒症后死亡率改善的相关性仍然存在。当然，我们注意到，在这个较小的人群中，BMI类别之间的差异不再具有统计学意义。这是由于样本量较小导致的估计值缺乏精确度，而不是由于在较小的人群中各组之间效应的最佳估计差异发生任何变化。即使在这项具有全国代表性的长达十年的纵向调查中，研究人群也太小，无法定义体重轨迹对严重脓毒症后死亡率的影响，无法精确地排除或排除有临床意义的效应量。本文中表达的观点是作者的观点，不一定反映退伍军人事务部或美国政府的立场或政策。部分由美国国立卫生研究院（Prescott博士）的赠款T32 HL 007749支持。Prescott博士和她的机构获得了NIH T32培训资助的资助，Iwashyna博士获得了NIH的文章研究支持，并披露了政府工作。他的机构获得了NIH/退伍军人事务部HSR&D的资助（IIR 11-109）（Iwashyna博士在败血症研究方面做了大量工作）。
Critical Care Medicine www.ccmjournal.org e31 initial analysis of 1,404 subjects (left column) (4), the adjusted probability of 1-year mortality by BMI category in all patients with two presepsis weight recordings (middle column), and adjusted mortality of patients by BMI category at 0% change in weight between the two preceding surveys (right column). Our results are consistent with our initial analysis and not statistically distinguishable from the original report. Reduced mortality with greater BMI categories persists in patients with stable weight trajectories (right column), as well as in patients with declining and rising weight trajectories, respectively (data not shown). Overall, we conclude that the association of BMI with improved mortality after severe sepsis persists after considering weight trajectory. We do note, of course, that in this smaller population, the differences between BMI categories are no longer statistically significant. This is a result of lack of precision in the estimates resulting from the smaller sample size not from any change in the best-estimated difference in effects between the groups in this smaller population. Even within this nationally representative, decade-long longitudinal survey, the study population is too small to define the impact of weight trajectory on mortality after severe sepsis to rule in or rule out clinically meaningful effect sizes precisely. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government. Supported, in part, by grants T32 HL007749 from the National Institutes of Health (Dr. Prescott) Dr. Prescott and her institution received grant support from a NIH T32 training grant and Dr. Iwashyna received support for article research from the NIH and disclosed government work. His institution received grant support (IIR 11–109) from the NIH/Department of Veterans Affairs HSR&D (Dr. Iwashyna does a lot of work in sepsis research).