Predictor of mortality in patients with amnitoic fluid embolism
Predictor of mortality in patients with amnitoic fluid embolism
复制标题
羊水栓塞患者死亡率的预测因素
DOI：
10.1111/jog.12278
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Oi H.
中科院分区：
文献类型：
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作者：
Yamasaki K;Miura K;Shimada T;Ikemoto R;Miura S;Murakami M;Sameshima T;Fujishita A;Kotera K;Kinoshita A;Yoshiura K;Masuzaki H;Oi H.
目的本研究的目的是评估建立羊水栓塞妇女死亡率预测因素的可能性。方法我们先前的报告确定了8个与羊水栓塞（AFE）死亡相关的因素：呼吸困难、心脏骤停、意识丧失、血清唾液素Tn大于47 U/mL、血清白细胞介素‐8大于100 pg/mL、阴道分娩、多胎分娩和足月分娩。在同一病例中，阳性致死因素的数量与可能致死因素的数量之比被计算为丰度比，之所以使用丰度比，是因为在登记时无法检索到所有患者的所有八个因素的信息。根据丰度比将患者组分为4个四分位数，并将每个四分位数的死亡率与1992年至2006年间纳入的130例AFE患者的总死亡率进行比较。该方法的有效性在2007年来自38例AFE患者队列的另一个数据集中得到证实。结果1992 ~ 2006年入选AFE患者的丰度比与各四分位数死亡率呈显著正相关（P< 0.01）。这一结果在2007年入组的AFE患者中也同样存在（P< 0.05）。因此，8种致死因素丰度比的增加导致病死率的增加。结论死亡因素丰度比可作为预测死亡率的有效指标，有望提高预后的准确性。
AimThe purpose of this study was to evaluate the possibility of establishing predictors of mortality in women with amniotic fluid embolism.MethodsOur previous report identified eight factors associated with amniotic fluid embolism (AFE) fatality: dyspnea, cardiac arrest, loss of consciousness, serum sialyl Tn greater than 47 U/mL, serum interleukin‐8 greater than 100 pg/mL, vaginal delivery, multiparity and term delivery. The ratio of the number of positive fatal factors to the number of possible fatal factors in the same case was calculated as the abundance ratio, which was used because information regarding all eight factors was not retrievable for all the patients at the time of registration. The patient group was divided into four quartiles based on this abundance ratio, and the mortality rate in each quartile was compared with the overall mortality rate among the 130 patients with AFE enrolled between 1992 and 2006. The validity of this approach was confirmed in another dataset from a cohort of 38 patients with AFE in 2007.ResultsA statistically significant positive correlation was observed between the abundance ratio and the mortality in each quartile (P< 0.01) for the patients with AFE enrolled between 1992 and 2006. This result was also found in the AFE patients enrolled in 2007 (P< 0.05). Thus, an increased in the abundance ratio of the eight fatal factors resulted in an increased case fatality rate.ConclusionThese data suggested that the abundance ratio of fatal factors may be a useful predictor of mortality and therefore may be expected to improve prognostic accuracy in the future.