D-二聚体/纤维蛋白原比值对老年血管外科危重症患者院内死亡的预测价值OA
Predictive Value of D-dimer/Fibrinogen Ratio for In-Hospital Mortality in Elderly Critically Ill Patients Undergoing Vascular Surgery
目的 探讨入院时D-二聚体/纤维蛋白原比值(DFR)对老年血管外科危重症患者院内死亡的预测价值.方法 回顾性选取 2021年1月至2025年6月首都医科大学附属北京友谊医院ICU收治的老年血管疾病患者132例,根据住院结局将患者分为存活组(114例)和死亡组(18例).采用多因素 Logistic回归分析老年血管外科危重症患者死亡的危险因素及其与器官功能的关联;采用ROC曲线评估DFR对老年血管外科危重症患者死亡的预测价值.结果 死亡组年龄、心率、乳酸、白细胞计数、尿素、D-二聚体、DFR、肌酐、N末端B型钠尿肽前体高于存活组,手术治疗、住院时间、非ICU住院时间、非机械通气时间、氧合指数低于存活组(P<0.05).多因素 Logistic 回归分析显示,DFR升高是老年血管疾病患者死亡的独立危险因素(OR=1.768,95%CI:1.013～3.097,P=0.047).ROC曲线评估显示,DFR预测老年血管疾病患者死亡的曲线下面积为0.952.此外,DFR升高与氧合指数降低、血小板减少相关(P<0.05),且在血栓相关性疾病亚组中预测价值更优.结论 DFR是预测老年血管外科危重症患者不良预后的独立危险因素.该指标能有效识别潜在的"肺-凝血轴"异常与隐匿性呼吸衰竭风险,有助于临床早期分层与干预.
Objective To explore the predictive value of the D-dimer to fibrinogen ratio(DFR)at admission for in-hospital mortality among elderly critically ill patients in vascular surgery.Methods A total of 132 elderly patients with vascular diseases admitted to the Intensive Care Unit(ICU)of Beijing Friendship Hospital,Capital Medical University from January 2021 to June 2025 were retrospectively enrolled and categorized into survival group(n=114)and non-survival group(n=18)according to in-hospital outcomes.Multivariate logistic regression was used to analyze the risk factors for mortality in elderly critically ill patients in vascular surgery and their association with organ function.ROC curves were utilized to evaluate the predictive value of DFR for mortality in these patients.Results The age,heart rate,lactate levels,white blood cell count,urea,D-dimer,DFR,creatinine,and N-terminal pro-B-type natriuretic peptide in the non-survival group were significantly higher than those in the survival group.Conversely,the surgical treatment total length of hospital stay,non-ICU stay,non-mechanical ventilation days,and oxygenation index were lower in the non-survival group than in the survival group(P<0.05).Multivariate logistic regression analysis indicated that an elevated DFR is an independent risk factor for mortality in elderly patients with vascular diseases(OR=1.768,95％CI:1.013-3.097,P=0.047).ROC curve analysis demonstrated that the AUC for DFR in predicting mortality among elderly patients with vascular diseases was 0.952.Furthermore,an elevated DFR was associated with a decreased oxygenation index and thrombocytopenia(P<0.05),and its predictive value was superior in the subgroup of thrombosis-related diseases.Conclusion DFR is an independent risk factor for predicting adverse prognoses in elderly critically ill patients in vascular surgery.This indicator can effectively identify potential abnormalities in the"lung-coagulation axis"and the risk of occult respiratory failure,thereby facilitating early clinical stratification and intervention.
刘钊;额尔敦必力格;刘彬;张立伟;冯海
首都医科大学附属北京友谊医院血管外科,北京 100050内蒙古自治区国际蒙医医院血管外科,呼和浩特 010020首都医科大学附属北京友谊医院血管外科,北京 100050首都医科大学附属北京友谊医院血管外科,北京 100050首都医科大学附属北京友谊医院血管外科,北京 100050
D-二聚体/纤维蛋白原比值老年血管外科危重症病死率免疫血栓
D-dimer/fibrinogen ratioelderlycritically ill vascular surgery patientsin-hospital mortalityimmunothrombosis
《转化医学杂志》 2026 (8)
1261-1265,5
首都卫生发展科研专项项目(2020-2-1102)
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