De-Ritis Ratio Is Associated with Mortality after Cardiac Arrest.
De-Ritis Ratio Is Associated with Mortality after Cardiac Arrest.
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De-Ritis 比率与心脏骤停后的死亡率相关
DOI：
10.1155/2020/8826318
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Chen L
中科院分区：
文献类型：
--
作者：
Lu Z;Ma G;Chen L
引言我们研究的目的是探讨天冬氨酸转氨酶/丙氨酸转氨酶（De-Ritis）比值与心脏骤停（CA）后结局的相关性。方法回顾性分析374例成人心脏骤停患者的临床资料。研究人群的信息来自Dryad Digital Repository。根据患者的De-Ritis比率将患者分为三分位数。Logistic回归危险分析用于评估De-Ritis比率与死亡率之间的独立关系。采用Kaplan-Meier法和log-rank检验估计各组的生存率。采用受试者工作特征曲线（ROC）分析比较生物标志物的预后能力。建立了一个结合De-Ritis比率的模型，并使用赤池信息准则（AIC）对其性能进行了评估。结果374例患者中，194例（51.9%）死于重症监护室（ICU），213例（57.0%）死于住院期间，226例（60.4%）神经功能不良。包括潜在混杂因素的Logistic回归分析显示，De-Ritis比值与死亡率独立相关，ICU死亡率（OR 1.455; 95% CI 1.088-1.946; p = 0.011）和住院死亡率（OR 1.378; 95% CI 1.031-1.842; p = 0.030）的风险超过一倍。通过ROC曲线评估的判别性能显示ICU死亡率的曲线下面积为0.611（95%CI 0.553-0.668），医院死亡率的曲线下面积为0.625（0.567-0.682）。此外，似然比检验（LRT）分析表明，与不含De-Ritis比的模型相比，结合De-Ritis比的模型具有更小的AIC和更高的似然比χ2得分。Kaplan-Meier曲线显示，De-Ritis比率三分位数3组的CA患者ICU死亡率明显更高（log-rank = 0.007）。结论CA患者入院时De-Ritis比值升高与ICU死亡率和住院死亡率显著相关。对De-Ritis比率的评估可能有助于识别死亡率高风险的群体。
Introduction The aim of our study was to explore the associations of the aspartate transaminase/alanine transaminase (De-Ritis) ratio with outcomes after cardiac arrest (CA). Methods This retrospective study included 374 consecutive adult cardiac arrest patients. Information on the study population was obtained from the Dryad Digital Repository. Patients were divided into tertiles based on their De-Ritis ratio. The logistic regression hazard analysis was used to assess the independent relationship between the De-Ritis ratio and mortality. The Kaplan-Meier method and log-rank test were used to estimate the survival of different groups. Receiver operating characteristic (ROC) curve analysis was utilized to compare the prognostic ability of biomarkers. A model combining the De-Ritis ratio was established, and its performance was evaluated using the Akaike information criterion (AIC). Results Of the 374 patients who were included in the study, 194 patients (51.9%) died in the intensive care unit (ICU), 213 patients (57.0%) died during hospitalization, and 226 patients (60.4%) had an unfavorable neurologic outcome. Logistic regression analysis including potentially confounding factors showed that the De-Ritis ratio was independently associated with mortality, yielding a more than onefold risk of ICU mortality (OR 1.455; 95% CI 1.088-1.946; p = 0.011) and hospital mortality (OR 1.378; 95% CI 1.031-1.842; p = 0.030). Discriminatory performance assessed by ROC curves showed an area under the curve of 0.611 (95% CI 0.553-0.668) for ICU mortality and 0.625 (0.567-0.682) for hospital mortality. Further, the likelihood ratio test (LRT) analysis showed that the model combining the De-Ritis ratio had a smaller AIC and higher likelihood ratio χ2 score than the model without the De-Ritis ratio. The Kaplan-Meier curves showed that the CA patients in the De-Ritis ratio tertile 3 group clearly had a significantly higher incidence of ICU mortality (log − rank = 0.007). Conclusion An elevated De-Ritis ratio on admission was significantly associated with ICU mortality and hospital mortality after CA. Assessment of the De-Ritis ratio might help identify groups at high risk for mortality.
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