Risk factors and in-hospital mortality of postoperative hyperlactatemia in patients after acute type A aortic dissection surgery.
Risk factors and in-hospital mortality of postoperative hyperlactatemia in patients after acute type A aortic dissection surgery.
复制标题
急性A型主动脉夹层术后患者术后高乳酸血症的危险因素及院内死亡率
DOI：
10.1186/s12872-021-02244-7
复制
发表时间：
2021-09-11
影响因子：
2.1
通讯作者：
Du X
中科院分区：
文献类型：
--
作者：
Wang S;Wang D;Huang X;Wang H;Le S;Zhang J;Du X
高乳酸血症可能由组织缺氧或非缺氧引起的产量增加引起。本研究的目的首先是确定Stanford A型急性主动脉夹层手术（AADS）术后高乳酸血症（POHL）的危险因素并构建预测模型，其次是评估POHL对预后的影响。本回顾性研究纳入2016年1月至2019年12月在武汉协和医院接受AADS治疗的患者。多因素logistic回归分析确定POHL的独立危险因素。基于这些因素建立了预测POHL的nomogram，并在原始数据集上进行了验证。绘制受试者工作特征曲线，评估术后乳酸水平预测住院死亡率的能力。共有188例患者在AADS后发生POHL（38.6%）。男性性别、手术史、红细胞输注和体外循环时间被认为是独立的预测因素。POHL预测模型的c指数为0.72，判别合理。通过目视检验和拟合优度检验对模型进行了很好的校正（Hosmer-Lemeshow χ2 = 10.25, P = 0.25）。模型的决策曲线和临床影响曲线显示了良好的临床应用价值。住院总死亡率为10.1%。术后乳酸水平对术后住院死亡率具有中等预测能力（c指数：0.72）。我们建立并验证了AADS患者POHL的预测模型，该模型可能在个人风险评估和预防干预方面具有临床应用价值。POHL可以很好地预测住院死亡率。在线版本包含补充材料，可在10.1186/s12872-021-02244-7获得。
Hyperlactatemia may be caused by increased production due to tissue hypoxia or non-hypoxia. The aim of this study was first to identify risk factors for postoperative hyperlactatemia (POHL) after Stanford type A acute aortic dissection surgery (AADS) and construct a predictive model, and second to evaluate the impact of POHL on prognosis. This retrospective study involved patients undergoing AADS from January 2016 to December 2019 in Wuhan Union Hospital. Multivariate logistic regression analysis was performed to identify independent risk factors for POHL. A nomogram predicting POHL was established based on these factors and was validated in the original dataset. The receiver operating characteristic curve was drawn to assess the ability of postoperative lactate levels to predict the in-hospital mortality. A total of 188 patients developed POHL after AADS (38.6%). Male gender, surgery history, red blood cell transfusion and cardiopulmonary bypass time were identified as independent predictors. The C-index of the prediction model for POHL was 0.72, indicating reasonable discrimination. The model was well calibrated by visual inspection and goodness-of-fit test (Hosmer–Lemeshow χ2 = 10.25, P = 0.25). Decision and clinical impact curves of the model showed good clinical utility. The overall in-hospital mortality rate was 10.1%. Postoperative lactate levels showed a moderate predictive power for postoperative in-hospital mortality (C-index: 0.72). We developed and validated a prediction model for POHL in patients undergoing AADS, which may have clinical utility in personal risk evaluation and preventive interventions. The POHL could be a good predictor for in-hospital mortality. The online version contains supplementary material available at 10.1186/s12872-021-02244-7.
登录
查看更多内容
影响因子：
3.4
作者：
Luehr, Maximilian;Merkle-Storms, Julia;Wahlers, Thorsten
通讯作者：
Wahlers, Thorsten
影响因子：
37.8
作者：
Donadee C;Raat NJ;Kanias T;Tejero J;Lee JS;Kelley EE;Zhao X;Liu C;Reynolds H;Azarov I;Frizzell S;Meyer EM;Donnenberg AD;Qu L;Triulzi D;Kim-Shapiro DB;Gladwin MT
通讯作者：
Gladwin MT
影响因子：
2.9
作者：
Chin-Yee, Ian H.;Gray-Statchuk, Leslie;Ellis, Christopher G.
通讯作者：
Ellis, Christopher G.
影响因子：
4.6
作者：
Demers, P;Elkouri, S;Cartier, R
通讯作者：
Cartier, R
影响因子：
3.4
作者：
Martens, Andreas;Beckmann, Erik;Shrestha, Malakh
通讯作者：
Shrestha, Malakh