Prognosis and its risk factors of patients with acute decompensated pulmonary hypertension in emergency intensive care unit
10.12007/j.issn.0258-4646.2024.06.012
- VernacularTitle:急诊重症监护室急性失代偿性肺高压患者的预后及其危险因素分析
- Author:
Xiaomeng YANG
1
;
Weichen TAO
Author Information
1. 中国医科大学附属盛京医院急诊科,沈阳 110004
- Keywords:
acute decompensated pulmonary hypertension;
emergency intensive care unit;
prognosis;
risk factor
- From:
Journal of China Medical University
2024;53(6):555-560,564
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the prognosis and its risk factors in patients with acute decompensatory pulmonary hypertension and provide a basis for their clinical management.Methods A total of 287 patients with acute decompensated pulmonary hypertension patients were selected in our hospital's Emergency Intensive Care Unit between April 2015 and April 2020.Patients were divided into a survival group(n=140)and a death group(n=147)according to in-hospital mortality status.The clinical characteristics,laboratory examination results,treatment plans,clinical events,and prognoses were compared between groups.The correlation between the in-hospital mortality rate,Euro-pean Society of Cardiology/European Respiratory Society(ESC/ERS)risk assessment system score,and Sequential Organ Failure Assessment(SOFA)score were evaluated using multivariate regression analysis.The ESC/ERS risk assessment system and SOFA scores were analyzed to evaluate the efficiency of clinical prognosis using a receiver operating characteristic(ROC)curve.Results Compared with the survival group,in the death group,the rates of intermediate and high risk in the ESC/ERS assessment and NYHAⅢ/Ⅳclass were increased(P<0.05),the mean pulmonary artery pressure and N-terminal pro-BNP(NT-proBNP)level were considerably elevated(P<0.05),and the levels of arte-rial partial pressure of oxygen(PaO2)and tricuspid annular plane systolic extrusion were considerably reduced(P<0.05).On a multivariate Cox regression analysis,a SOFA score≥8,high ESC/ERS risk assessment score,and high NT-proBNP and PaO2 levels were independent risk factors for in-hospital mortality(all P<0.05).A ROC curve analysis showed that the area under the curve of the ESC/ERS risk assessment combined with SOFA score was the largest at 0.877(P<0.001),with a sensitivity of 92.5%and specificity of 83.0%.Conclusion High risk on an ESC/ERS risk assessment and a SOFA score≥8 are independent risk factors of in-hospital mortality among patients with acute decom-pensatory pulmonary hypertension.The ESC/ERS risk assessment and SOFA score can be used to evaluate the prognosis of patients with acute decompensated pulmonary hypertension in the Intensive Care Unit;moreover,their combined use has better predictive efficacy.
