Novel Prognostic Predictor for Primary Pulmonary Hypertension: Focus on Blood Urea Nitrogen.
Novel Prognostic Predictor for Primary Pulmonary Hypertension: Focus on Blood Urea Nitrogen.
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原发性肺动脉高压的新型预后预测因子：关注血尿素氮
DOI：
10.3389/fcvm.2021.724179
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发表时间：
2021
影响因子：
3.6
通讯作者：
Hou J
中科院分区：
文献类型：
--
作者：
Hu B;Xu G;Jin X;Chen D;Qian X;Li W;Xu L;Zhu J;Tang J;Jin X;Hou J
背景：原发性肺动脉高压（PPH）是一种与死亡率增加相关的危及生命的疾病。尿素循环途径在 PPH 严重程度和治疗反应中起着重要作用。关于血尿素氮 (BUN) 与 PPH 预后之间的关系知之甚少。方法：从重症监护医疗信息集市 III (MIMIC-III) 数据库中提取临床数据。纳入数据库中患有原发性肺动脉高压（PPH）的成年患者（≥18岁）。使用 Spearman 相关分析 BUN 与住院时间和重症监护病房 (ICU) 住院时间的关系。采用卡方检验分析BUN与死亡率的相关性。使用 Kaplan-Meier 方法估计生存曲线并通过对数秩检验进行比较。使用多变量逻辑回归将 BUN 确定为死亡率的独立预后因素。使用受试者工作特征（ROC）曲线和曲线下面积（AUC）来分析死亡率的敏感性和特异性。结果：共有263名符合选择标准的患者入组。 BUN 与住院时间和 ICU 住院时间显着正相关（住院时间：ρ = 0.282，ICU 住院时间：ρ = 0.276；所有 P < 0.001）。 BUN 较高四分位数的 PPH 患者的医院、90 天和 4 年死亡率较高（医院：P = 0.002；90 天：P = 0.025；4 年：P < 0.001）。 Kaplan-Meier 生存曲线显示，BUN 四分位数较高的患者的 4 年生存率往往较低（Q1：7.65%，Q2：10.71%；Q3：14.80%，Q4：16.84%；P < 0.0001）。 Logistic 回归分析发现 BUN 与死亡率存在显着相关性（医院：OR = 1.05，95% CI = 1.02–1.08，P = 0.001；90 天：OR = 1.02，95% CI = 1.00–1.05，P = 0.027；4 年：OR = 1.05，95% CI = 1.02–1.08，P = 0.001）。 ROC和AUC结果显示BUN对死亡率的诊断性能中等。结论：BUN与PPH患者住院时间、ICU住院时间呈正相关。 BUN 较高与 PPH 患者较高的住院死亡率、90 天死亡率和 4 年死亡率以及较低的 4 年生存率相关。这些发现表明 BUN 可以成为 PPH 的一种新的潜在预后预测因子。
Background: Primary pulmonary hypertension (PPH) is a life-threatening disease associated with increased mortality. The urea cycle pathway plays a major role in PPH severity and treatment response. Little is known about the association of the blood urea nitrogen (BUN) and PPH prognosis. Methods: Clinical data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. Adult patients (≥18 years) patients with primary pulmonary hypertension (PPH) in the database were enrolled. Spearman correlation was used to analyze the association of BUN with length of hospital and intensive care unit (ICU) stays. The chi-square test was used to analyze the association of BUN with mortality rate. Survival curves were estimated using the Kaplan-Meier method and compared by the log-rank test. Multivariable logistic regression was used to identify the BUN as an independent prognostic factor of mortality. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to analyze the sensitivity and specificity for mortality. Results: In total, 263 patients who met the selection criteria were enrolled. BUN was significantly positively associated with length of hospital stay and ICU stay (hospital stay: ρ = 0.282, ICU stay: ρ = 0.276; all P < 0.001). Higher hospital, 90-day and 4-year mortality rates were observed in the higher BUN quartile of PPH patients (hospital: P = 0.002; 90-day: P = 0.025; 4-year: P < 0.001). The Kaplan-Meier survival curves showed that patients in higher BUN quartile tended to have lower 4-year survival (Q1:7.65%, Q2: 10.71%; Q3: 14.80%, Q4: 16.84%; P < 0.0001). Logistic regression analyses found a significant association of BUN and mortality (hospital: OR = 1.05, 95% CI = 1.02–1.08, P = 0.001; 90-day: OR = 1.02, 95% CI = 1.00–1.05, P = 0.027; 4-year: OR = 1.05, 95% CI = 1.02–1.08, P = 0.001). Results of ROC and AUC showed that the diagnostic performance of BUN for mortality was moderately good. Conclusion: BUN was positively correlated with the length of hospital stay and ICU stay of PPH patients. Higher BUN was associated with higher hospital, 90-day and 4-year mortality and lower 4-year survival of PPH patients. These findings indicate that BUN can be a novel potential prognostic predictor for PPH.
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影响因子：
8.9
作者：
Dhaun, Neeraj;Vachiery, Jean-Luc;Webb, David J.
通讯作者：
Webb, David J.
影响因子：
7.4
作者：
Tabima, Diana M.;Frizzell, Sheila;Gladwin, Mark T.
通讯作者：
Gladwin, Mark T.
影响因子：
9.8
作者：
Johnson AE;Pollard TJ;Shen L;Lehman LW;Feng M;Ghassemi M;Moody B;Szolovits P;Celi LA;Mark RG
通讯作者：
Mark RG
DOI：
10.1111/apa.12717
发表时间：
2014-10
期刊：
Acta paediatrica (Oslo, Norway : 1992)
影响因子：
--
作者：
Trittmann JK;Nelin LD;Zmuda EJ;Gastier-Foster JM;Chen B;Backes CH;Frick J;Vaynshtok P;Vieland VJ;Klebanoff MA
通讯作者：
Klebanoff MA
影响因子：
3.6
作者：
Maarsingh, Harm;Pera, Tonio;Meurs, Herman
通讯作者：
Meurs, Herman