Decreased urine output is associated with increased in-hospital mortality from sepsis-associated acute respiratory distress syndrome

作者全名："Cao, Fuli; Liu, Yiting; Lou, Yake; Hu, Tianyang"

作者地址："[Cao, Fuli] Army Med Univ, Southwest Hosp, Dept Geriatr & Special Serv Med, Affiliated Hosp 1, Chongqing 400038, Peoples R China; [Liu, Yiting] Chongqing Med Univ, Dept Crit Care Med, Affiliated Hosp 2, Chongqing 400010, Peoples R China; [Lou, Yake] Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, Chongqing 400010, Peoples R China; [Hu, Tianyang] Chongqing Med Univ, Precis Med Ctr, Affiliated Hosp 2, Chongqing 400010, Peoples R China"

通信作者："Lou, YK (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, Chongqing 400010, Peoples R China.; Hu, TY (通讯作者)，Chongqing Med Univ, Precis Med Ctr, Affiliated Hosp 2, Chongqing 400010, Peoples R China."

来源：SIGNA VITAE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000989999900014

JCR分区：Q3

影响因子：1.1

年份：2023

卷号：19

期号：3

开始页：112

结束页：120

文献类型：Article

关键词：Urine output; Sepsis; Acute respiratory distress syndrome; In-hospital mortality; MIMIC-IV

摘要："The relationship between urine output (UO) and in-hospital mortality in patients with sepsis-associated acute respiratory distress syndrome (ARDS) has not been elucidated. The demographic and clinical characteristics of patients from the intensive care unit with sepsis-associated ARDS in the Medical Information Mart for Intensive Care-IV database were collected, and binomial logistic regression was performed to determine whether UO was an independent risk factor for in-hospital death. Using the Logistic Organ Dysfunction System (LODS) and Sequential Organ Failure Assessment (SOFA) as a reference, receiver operating characteristic (ROC) curves were drawn to analyze the efficacy of UO in predicting in-hospital mortality, and the Kaplan-Meier curve was drawn with the optimal cut-off value of the ROC curve. Decision curve analysis (DCA) was performed to assess the clinical net benefit of UO in predicting in-hospital mortality. UO was an independent risk factor for in-hospital mortality in patients with sepsis -associated ARDS. The area under the ROC (AUC) for UO in predicting in-hospital mortality was 0.712, which was comparable to LODS and SOFA. The patients were grouped by the optimal UO cut-off value (1515 mL/day) identified by the ROC curve. The results showed that the median in-hospital survival time for the low-UO group was 20.565 days, and that of the high-UO group was 84.670 days. The risk of in-hospital death of the low-UO group was 3.0792 times that of the high-UO group. DCA showed that when using UO to predict in-hospital mortality, the clinical net benefit was higher than LODS or SOFA at almost all available threshold probabilities, particularly when the threshold probability was between 0.2 and 0.4. As a result, UO showed moderate efficacy in predicting in-hospital mortality, and when used to predict the in-hospital mortality of patients with sepsis-related ARDS, its clinical net benefit was higher than that of LODS or SOFA."

基金机构：　

基金资助正文：