老年医学与保健2025，Vol.31Issue(5)：1354-1359,6.
基于白蛋白的三种比值指标对中老年危重症消化道出血患者30 d病死率的预测价值
Predictive value of three albumin-based ratio indices for 30-day mortality in middle-aged and elderly critically ill patients with gastrointestinal bleeding
摘要
Abstract
Objective To compare the value of the lactate/albumin ratio(LAR),red blood cell distribution width/al-bumin ratio(RAR),and blood urea nitrogen/albumin ratio(BAR)in predicting 30-day mortality in middle-aged and elderly critically ill patients with gastrointestinal bleeding(GIB).Methods The clinical data of 118 middle-aged and elderly critically ill patients with a primary diagnosis of GIB were extracted from the MIMIC-Ⅳ v3.1 database.Patients were divided into death group(n=46)and survival group(n=72)based on their 30-day survival status.Logistic regression was used to identify inde-pendent risk factors for mortality.The predictive performance of LAR,RAR and BAR was assessed using the area under the re-ceiver operating characteristic curve(AUC).Survival differences based on LAR level were analyzed with Kaplan-Meier curves.Results Among the 118 patients included,46 died within 30 days,resulting in a mortality rate of 39.0％.The LAR in the death group was significantly higher than that in the survival group(P＜0.05),while no significant differences were found in RAR and BAR between the two groups(P＞0.05).Logistic regression analysis identified LAR as an independent risk factor for mortality(OR=3.817,95％CI:1.987-8.745,P＜0.001).The AUC of LAR was 0.764(95％CI:0.674-0.854),which was significantly higher than those of RAR(0.589,95％CI;0.483-0.695,P=0.004)and BAR(0.602,95％CI:0.496-0.708,P=0.025).Kaplan-Meier analysis showed that patients with LAR＞1.24 had a significantly lower survival rate(x2=56.12,P＜0.001).Conclusion Among the three albumin-based ratio indices,LAR demonstrated the best predictive performance for 30-day mortality in middle-aged and elderly critically ill patients with GIB.It may have high clinical value,but multicenter studies are still needed to verify its stability and generalizability.关键词
中老年/消化道出血/重症监护病房/白蛋白/乳酸/预后Key words
middle-aged and elderly/gastrointestinal bleeding/intensive care unit/albumin/lactate/prognosis引用本文复制引用
祝晓清,孙莹莹,杨光耀,徐英..基于白蛋白的三种比值指标对中老年危重症消化道出血患者30 d病死率的预测价值[J].老年医学与保健,2025,31(5):1354-1359,6.基金项目
2023年度上海市浦东新区卫生健康委员会卫生科技项目(PW2023A-04) （PW2023A-04）
复旦大学附属浦东医院扶持学科建设资助(Yjfcxk2025-08) （Yjfcxk2025-08）
2025年"复旦大学-复星护理科研基金"项目(FNF202563) （FNF202563）
