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응급실을 방문한 패혈증 환자의 사망 예측인자로서 허혈성변형알부민(ischemia modified albumin) 측정의 유용성

Albumin-adjusted ischemia modified albumin as a predictor of mortality in patients with sepsis

대한응급의학회지 2020년 31권 5호 p.440 ~ 447
정동학, 홍대영, 김신영, 김종원, 박상오, 이경룡, 백광제,
소속 상세정보
정동학 ( Jeong Dong-Hak ) - Konkuk University School of Medicine Department of Emergency Medicine
홍대영 ( Hong Dae-Young ) - Konkuk University School of Medicine Department of Emergency Medicine
김신영 ( Kim Sin-Young ) - Konkuk University School of Medicine Department of Emergency Medicine
김종원 ( Kim Jong-Won ) - Konkuk University School of Medicine Department of Emergency Medicine
박상오 ( Park Sang-O ) - Konkuk University School of Medicine Department of Emergency Medicine
이경룡 ( Lee Kyeong-Ryong ) - Konkuk University School of Medicine Department of Emergency Medicine
백광제 ( Baek Kwang-Je ) - Konkuk University School of Medicine Department of Emergency Medicine

Abstract


Objective: Ischemia-modified albumin (IMA) is a marker of oxidative stress and hypoperfusion that is usually used for acute coronary syndrome. Patients with sepsis undergo hypoperfusion and multi-organ failure that results in death. This study evaluated the efficacy of the albumin-adjusted IMA (AAIMA) level in the emergency department (ED) to predict the 30-day mortality of patients with sepsis

Methods: A retrospective analysis study of patients with sepsis was conducted from June 2018 to April 2019 in ED. The data were obtained from the medical records of the patients, and the blood test results were taken from the initial blood tests at the ED. The data and blood test results of the 30-day survival and non-survival groups were compared.

Results: Two hundred thirty-three patients were included. The mean age was 75 years, and the overall mortality was 20.6%. The non-survival group had higher AAIMA levels than the survival group (75.1 U/mL vs. 68.4 U/mL). The area under the receiver operating characteristic curve of AAIMA to predict the 30-day mortality was 0.789 (95% confidence interval, 0.730-0.840; P<0.001), and the sensitivity and specificity of predicting mortality was 68.8% and 78.2%, respectively, after setting the AAIMA cutoff value to 72.9 U/mL.

Conclusion: The initial albumin-adjusted IMA on ED admission has potential as a predictor of the 30-day mortality in patients with sepsis.

키워드

Sepsis; Biomarkers; Mortality

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