SCI REP:术前改良体重指数对术后1年死亡率的预测价值!

2018-03-16 xing.T MedSci原创

由此可见,低白蛋白是术后1年死亡率三个变量重最强的独立预测因子(白蛋白、cBMI和mBMI)。将cBMI加入到白蛋白中并不能增加白蛋白AUC的有效性。

血清白蛋白与传统的BMI(cBMI)是常用的营养状态指数。因为Cbmi并不能反映液体积累,改进的体重指数(mBMI,血清白蛋白×cBMI)是一个更准确的衡量营养状况指标。

近日,Scientific reports杂志上发表了一篇研究文章,这项研究调查了术前mBMI与术后1术后1年死亡率之间的相关性,与血清白蛋白和cBMI进行比较。研究人员对2011年1月1日至2015年12月31日期间在研究者所在的三级医院接受外科手术的80969名成人患者的病历进行回顾性分析。

研究人员发现术后1年死亡率分别 随着cBMI、mBMI和白蛋白的降低而增加(P<0.001)。当考虑到cBMI与白蛋白之间的相互作用,白蛋白是术后1年死亡率唯一重要的因素[比值比:0.377,95%可信区间(0.245–0.579),P<0.001],而cBMI或相互作用(cBMI*白蛋白)差异并不显著(P>0.05  )。调整后的曲线下面积(AUC)在整体模型重(cBMI +白蛋白+ cBMI*白蛋白)为最高(0.885);调整后的mBMI和白蛋白之间AUC没有显著差异(P=0.558)。

由此可见,低白蛋白是术后1年死亡率三个变量重最强的独立预测因子(白蛋白、cBMI和mBMI)。将cBMI加入到白蛋白中并不能增加白蛋白AUC的有效性。

原始出处:

Tak Kyu Oh,et al. Value of Preoperative Modified Body Mass Index in Predicting Postoperative 1-Year Mortality.Scientific reports.2018. https://www.nature.com/articles/s41598-018-22886-6

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1626481, encodeId=53ed162648114, content=<a href='/topic/show?id=558b100221c7' target=_blank style='color:#2F92EE;'>#预测价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100221, encryptionId=558b100221c7, topicName=预测价值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5f621038683, createdName=changjitao2016, createdTime=Sat Mar 17 22:48:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296850, encodeId=552f296850a6, content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 16 18:14:46 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296751, encodeId=940c296e5179, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Fri Mar 16 10:00:32 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296734, encodeId=2155296e342a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri Mar 16 08:45:39 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296727, encodeId=cb1e296e278e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Mar 16 08:24:58 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
    2018-03-16 虈亣靌

    好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛.

    0

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    2018-03-16 139****5926

    好好文章学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1626481, encodeId=53ed162648114, content=<a href='/topic/show?id=558b100221c7' target=_blank style='color:#2F92EE;'>#预测价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100221, encryptionId=558b100221c7, topicName=预测价值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5f621038683, createdName=changjitao2016, createdTime=Sat Mar 17 22:48:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296850, encodeId=552f296850a6, content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 16 18:14:46 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296751, encodeId=940c296e5179, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Fri Mar 16 10:00:32 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296734, encodeId=2155296e342a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri Mar 16 08:45:39 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296727, encodeId=cb1e296e278e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Mar 16 08:24:58 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
    2018-03-16 龙胆草

    学习谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1626481, encodeId=53ed162648114, content=<a href='/topic/show?id=558b100221c7' target=_blank style='color:#2F92EE;'>#预测价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100221, encryptionId=558b100221c7, topicName=预测价值)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5f621038683, createdName=changjitao2016, createdTime=Sat Mar 17 22:48:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296850, encodeId=552f296850a6, content=好文.值得点赞!认真学习了.把经验应用于实践.为患者解除病痛., beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Fri Mar 16 18:14:46 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296751, encodeId=940c296e5179, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Fri Mar 16 10:00:32 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296734, encodeId=2155296e342a, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Fri Mar 16 08:45:39 CST 2018, time=2018-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296727, encodeId=cb1e296e278e, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Mar 16 08:24:58 CST 2018, time=2018-03-16, status=1, ipAttribution=)]
    2018-03-16 1ddf0692m34(暂无匿称)

    学习了.谢谢分享

    0

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Obstet Gynecol:卵巢癌患者术前血小板和白细胞升高,预示术后不良结局

目的:验证血小板升高和白细胞升高与术后并发症和死亡率有相关性。方法:纳入经美国外科医师国家外科质量改进项目鉴定后的2005年至2012年间接受首次手术治疗的卵巢癌病例。将血小板大于450000/mm的定义为血小板升高,白细胞大于10000/mm的定义为白细胞升高。研究者计算术后30天内的并发症发生率和死亡率。使用描述性统计分析和多变量logistic回归分析。结果:纳入1072例病例。血小板的例数