急性主动脉夹层院内死亡的危险因素

发布时间：2018-03-28 14:26

  本文选题：急性主动脉夹层　切入点：院内死亡率　出处：《中华高血压杂志》2017年04期

【摘要】：目的研究急性主动脉夹层(AAD)患者临床特点及院内死亡危险因素,建立风险预测模型。方法回顾分析2004年1月至2016年5月武警总医院住院治疗的AAD患者病史资料,应用单因素及多因素Logistic回归分析确定患者院内死亡的独立危险因素,建立风险预测模型,并通过Hosmer-Lemeshow拟合优度检验和受试者工作特征(ROC)曲线下面积判断该模型对AAD患者院内死亡的预测能力。结果所有196例AAD患者中36例患者住院期间死亡,院内死亡率为18.4%。多因素Logistic回归分析显示,AAD院内死亡的独立危险因素包括:年龄≥65岁(OR=4.57,P=0.010),低血压(OR=9.58,P=0.001),急性肾损伤(OR=11.42,P=0.001),缺血性并发症(OR=6.35,P=0.001),神经系统症状(OR=7.60,P=0.020),A型夹层(OR=7.59,P=0.001),Hosmer-Lemeshow拟合优度检验P=0.18,ROC曲线下面积为0.92。结论年龄≥65岁、低血压、急性肾损伤、缺血性并发症、神经系统症状及A型夹层为AAD患者院内死亡的独立危险因素。
[Abstract]:Objective to study the clinical characteristics and risk factors of hospital death in patients with acute aortic dissection (AAD) and to establish a risk prediction model. Methods the history of AAD patients hospitalized in Armed Police General Hospital from January 2004 to May 2016 was analyzed retrospectively. Univariate and multivariate Logistic regression analysis was used to determine the independent risk factors of hospital mortality, and a risk prediction model was established. The predictive ability of the model to hospital death of AAD patients was evaluated by Hosmer-Lemeshow goodness test and area under the operating characteristics curve. Results 36 out of 196 AAD patients died in hospital. The hospital mortality rate was 18.44.The independent risk factors for hospital mortality by multivariate Logistic regression analysis were as follows: the age 鈮，

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