Povišeni omjer laktat/albumin povezan je s lošom prognozom u bolesnika sa sepsom: sustavni pregled i meta-analiza
odnos laktat/albumin i sepsa
Sažetak
Pozadina: Cilj ove studije bio je istražiti povezanost između omjera laktat/albumin i prognoze bolesnika sa sepsom.
Metode: Izvršeno je računalno pretraživanje u Pubmedu, EMbaseu, Ovidu, Medlineu i Google Scholaru kako bi se usporedile relevantne studije. Rezultati su uspoređeni korištenjem standardiziranih srednjih razlika (SMD)/odds ratio (OR) i 95% intervala pouzdanosti (CI). U ovu studiju uključene su i prospektivne i retrospektivne kohortne studije.
Rezultati: Uključeno je ukupno devet studija koje su uključivale 3039 sudionika. Skupna analiza otkrila je da su preživjeli imali značajno niži omjer laktat/albumin od onih koji nisu preživjeli (SMD=-2,02, 95% CI: -2,76 do -1,28, I2=97,4%). Nadalje, naši su rezultati također pokazali da je povišeni omjer laktat/albumin neovisni faktor rizika za smrtnost (OR=2,16, 95% CI: 1,58 do 2,95, I2=76,2%) i sindrom višestruke disfunkcije organa (MODS) (OR=3,41, 95% CI: 1,78 do 6,50, I2=0,0%) u septičkih bolesnika. Štoviše, prema rezultatima površine ispod krivulje (AUC), omjer laktat/albumin također je pokazao dobru diskriminatornu snagu za predviđanje smrtnosti (AUC=0,75, 95% CI: 0,68 do 0,84, I2=92,9%) i MODS (AUC=0,78). , 95% CI: 0,68 do 0,91, I2=65,1%) u septičkih bolesnika. Beggov i Eggerov test sugerirao je da u uključenim studijama nema pristranosti u objavljivanju.
Zaključci: Naši su rezultati istaknuli da je omjer laktat/albumin važan prognostički čimbenik za MODS i mortalitet u pacijenata sa sepsom, s dobrim mogućnostima identificiranja MODS-a i mortaliteta.
Reference
Reference
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