Association between albumin infusion and septic patients with coronary heart disease: A retrospective study based on medical information mart for intensive care III database.
Association between albumin infusion and septic patients with coronary heart disease: A retrospective study based on medical information mart for intensive care III database.
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白蛋白输注与脓毒症冠心病患者的关联：基于重症监护III数据库医疗信息集市的回顾性研究
DOI：
10.3389/fcvm.2022.982969
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发表时间：
2022
影响因子：
3.6
通讯作者：
Peng, Qianyi
中科院分区：
文献类型：
--
作者：
Ye, Zhiwen;Gao, Ming;Ge, Chenglong;Lin, Wenrui;Zhang, Lina;Zou, Yu;Peng, Qianyi
冠心病（CHD）是重症监护病房（ICU）患者的常见合并症，尤其是老年患者。这一特定人群在脓毒症期间可能有更差的状况，并且它对临床实践提出了压倒性的挑战。既往研究提示冠心病患者发生心血管事件的危险性增加，低白蛋白浓度影响稳定型冠心病患者的预后。败血症患者的低白蛋白血症是常见的，由于营养失调，过度消费，和泄漏。白蛋白是脓毒症患者常用的复苏液。然而，在脓毒症和CHD患者中输注白蛋白的研究很少。输注白蛋白在脓毒症和CHD患者中的疗效和安全性尚不清楚。因此，我们收集了Mimic-III（Mimic-III）的医学信息，并比较了脓毒症CHD患者中白蛋白组和非白蛋白组之间28或90天时的全因死亡率和心血管死亡率。我们的研究共纳入了2，027例脓毒症和CHD患者，其中白蛋白组405例，非白蛋白组1，622例。经过倾向评分匹配（PSM），350对被纳入我们的研究。与非白蛋白组相比，白蛋白组在28天全因死亡率方面的生存获益改善（风险比[HR]，0.54; 95% CI：0.38-0.78; p = 0.0009）。然而，在90天生存获益方面未检测到差异（HR，0.80，95% CI：0.60-1.06，p = 0.1207）。第28天和第90天时，白蛋白输注均未逆转心血管死亡率（心血管死亡率：28天，HR，0.52，95% CI：0.23-1.19，p = 0.1218; 90天，HR，0.66，95% CI：0.33-1.33，p = 0.2420）。
Coronary heart disease (CHD) is a common comorbidity in intensive care unit (ICU) patients, particularly in the elderly. This particular population may have worse conditions during sepsis, and it presents an overwhelming challenge for clinical practice. Previous studies suggested that patients with CHD have an increased risk of cardiovascular events, and low albumin concentration worsens the prognosis of patients with stable CHD. Hypoalbuminemia in patients with sepsis is common due to nutritional disorders, excessive consumption, and leakage. Albumin is a fluid often used for resuscitation in patients with sepsis. However, albumin infusion in patients with sepsis and CHD has rarely been studied. The effects and safety of albumin infusion in patients with sepsis and CHD remain unclear. Therefore, we collected medical information from Mimic-III (Mimic-III) and compared the all-cause mortality and cardiovascular mortality at 28- or 90-day between the albumin and non-albumin groups in septic patients with CHD. A total of 2,027 patients with sepsis and CHD were included in our study, with 405 in the albumin group and 1,622 in the non-albumin group. After propensity score matching (PSM), 350 pairs were included in our study. Improved survival benefits were found in the albumin group at the 28-day all-cause mortality compared with the non-albumin group (hazard ratio [HR], 0.54; 95% CI: 0.38–0.78; p = 0.0009). However, no difference was detected in the 90-day survival benefits (HR, 0.80, 95% CI: 0.60–1.06, p = 0.1207). Albumin infusion did not reverse cardiovascular mortality neither at 28th day nor at 90th day (cardiovascular mortality: 28 days, HR, 0.52, 95% CI: 0.23–1.19, p = 0.1218; 90 days, HR, 0.66, 95% CI: 0.33–1.33, p = 0.2420).
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影响因子：
38.9
作者：
Dellinger RP;Levy MM;Rhodes A;Annane D;Gerlach H;Opal SM;Sevransky JE;Sprung CL;Douglas IS;Jaeschke R;Osborn TM;Nunnally ME;Townsend SR;Reinhart K;Kleinpell RM;Angus DC;Deutschman CS;Machado FR;Rubenfeld GD;Webb S;Beale RJ;Vincent JL;Moreno R;Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
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Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
影响因子：
8.3
作者：
Suarez JI;Martin RH;Calvillo E;Dillon C;Bershad EM;Macdonald RL;Wong J;Harbaugh R;ALISAH Investigators
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ALISAH Investigators
影响因子：
9.8
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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
影响因子：
120.7
作者：
Annane, Djillali;Siami, Shidasp;Chevret, Sylvie
通讯作者：
Chevret, Sylvie
影响因子：
8.8
作者：
Ernest, D;Belzberg, AS;Dodek, PM
通讯作者：
Dodek, PM