接受心脏瓣膜置换术的老年患者术后血尿素氮对院内及术后1年死亡率的预测价值
DU Su-ling
CHE Shuai-zheng
CHEN Yan-li
Department of Geriatrics,Guangdong Provincial Geriat-rics Institute,Guangdong Provincial People's Hospital,Guang-dong Academy of Medical Sciences,Southern Medical Univer-sity,Guangzhou 510080,China
摘要：Background Previous studies have shown a relationship between elevated blood urea nitrogen(BUN)level and poor outcomes in several diseases,but data on the prognostic significance of postoperative BUN in elderly pa-tients undergoing valve replacement surgery(VRS)remained sparse.Methods BUN was measured immediately after VRS.A total of 3118 elderly patients were enrolled and divided into four groups according to the quartiles of postoperative BUN:Q1,<5.6 mmol/L;Q2,5.6-6.8 mmol/L;Q3,6.8-8.4 mmol/L and Q4,≥8.4 mmol/L.The associ-ations of postoperative BUN with in-hospital and 1-year mortality were evaluated.Results The incidence of in-hospital death(1.0%vs.3.3%vs.3.3%vs.8.4%,P<0.001)and major adverse clinical events(5.1%vs.7.8%vs.9.9%vs.19.1%,P<0.001)was significantly higher in patients with a high BUN level.BUN was independently asso-ciated with all-cause in-hospital mortality[odds ratio(OR):1.11,95%confidential interval(CI):1.07-1.16,P<0.001].The receiver operating characteristic(ROC)curve showed that BUN>9 mmol/L had a sensitivity of 48.4%and specificity of 81.8%for predicting in-hospital death[area under curve(AUC):0.705,95%CI:0.658-0.753,P<0.001].Kaplan-Meier survival curves showed that patients with BUN>9 mmol/L had a higher one-year mortality than those without(log-rank test:91.7,P<0.001).Multivariate analysis showed that BUN>9 mmol/L was an inde-pendent predictor for one-year mortality[hazard ratio(HR):1.67,95%CI:1.23-2.28,P=0.001].Conclusions This study provided strong evidence that increased postoperative BUN level was associated with poor prognosis in elderly patients undergoing VRS.[S Chin J Cardiol 2025;26(2):107-113]
机标关键词：心脏瓣膜置换术老年患者1年死亡率血尿素氮预测价值
论文发表日期：2025-06-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 107-113,120 )
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