Nucleated Red Blood Cells as Predictors of All-Cause Mortality in Cardiac Intensive Care Unit Patients: A Prospective Cohort Study
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29
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article
Data de publicação
2015
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PUBLIC LIBRARY SCIENCE
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MONTEIRO JUNIOR, Jose Gildo de Moura
TORRES, Dilenia de Oliveira Cipriano
SILVA, Maria Cleide Freire Clementino da
RAMOS, Tadzia Maria de Brito
ALVES, Marilene Leite
NUNES FILHO, Wellington Jorge
DAMASCENO, Edgar Paulo
BRUNET, Antonio Fernandes
PEDROSA, Rodrigo Pinto
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Citação
PLOS ONE, v.10, n.12, article ID e0144259, 10p, 2015
Resumo
Background The presence of nucleated red blood cells (NRBCs) in the peripheral blood of critically ill patients is associated with a poorer prognosis, though data on cardiovascular critical care patients is lacking. The aim of the present study was to assess the role of NRBCs as a predictor of intensive care unit (ICU) and in hospital all-cause mortality among cardiologic patients. Methods NRBCs were measured daily in consecutive cardiac ICU patients, including individuals with both coronary and non-coronary acute cardiac care. We excluded patients younger than 18 years, with cancer or hematological disease, on glucocorticoid therapy, those that were readmitted after hospital discharge and patients who died in the first 24 hours after admission. We performed a multiple logistic analysis to identify independent predictors of mortality. Results We included 152 patients (60.6 +/- 16.8 years, 51.8% female, median ICU stay of 7 [4-11] days). The prevalence of NRBCs was 54.6%(83/152). The presence of NRBC was associated with a higher ICU mortality (49.4% vs 21.7%, P<0.001) as well as in-hospital mortality (61.4% vs 33.3%, p = 0.001). NRBC were equally associated with mortality among coronary disease (64.71% vs 32.5%[OR 3.80; 95% CI: 1.45-10.0; p = 0.007]) and non-coronary disease patients (61.45% vs 33.3% [OR 3.19; 95% CI: 1.63-6.21; p<0.001]). In a multivariable model, the inclusion of NRBC to the APACHE II score resulted in a significant improvement in the discrimination (p = 0.01). Conclusions NRBC are predictors of all-cause in-hospital mortality in patients admitted to a cardiac ICU. This predictive value is independent and complementary to the well validated APACHE II score.
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Referências
- Azab B, 2010, AM J CARDIOL, V106, P470, DOI 10.1016/j.amjcard.2010.03.062
- Danise P, 2012, CLIN CHEM LAB MED, V50, P357, DOI 10.1515/CCLM.2011.766
- Dellinger RP, 2013, INTENS CARE MED, V39, P165, DOI 10.1007/s00134-012-2769-8
- Desai S, 2012, SURG INFECT, V13, P360, DOI 10.1089/sur.2011.089
- Fraker TD, 2007, CIRCULATION, V116, P2762, DOI 10.1161/CIRCULATIONAHA.107.187930
- Hamm CW, 2011, EUR HEART J, V32, P2999, DOI 10.1093/eurheartj/ehr236
- KNAUS WA, 1985, CRIT CARE MED, V13, P818, DOI 10.1097/00003246-198510000-00009
- Kuert S, 2011, CLIN CHEM LAB MED, V49, P257, DOI 10.1515/CCLM.2011.041
- Labriolle AD, 2010, EUROPEAN HEART J, V31, P1079, DOI [10.1093/eurheartj/ehp594, DOI 10.1093/EURHEARTJ/EHP594]
- Nakul-Aquaronne D, 2003, J CLIN LAB ANAL, V17, P113, DOI 10.1002/jcla.10083
- Nunez J, 2010, CORONARY ARTERY DIS, V21, P1, DOI 10.1097/MCA.0b013e328332ee15
- Pipitone S, 2012, CLIN CHEM LAB MED, V50, P1857, DOI 10.1515/cclm-2012-0148
- Rogers HM, 2008, EXP HEMATOL, V36, P17, DOI 10.1016/j.exphem.2007.08.014
- Shah R, 2012, AM J SURG, V203, P343, DOI 10.1016/j.amjsurg.2011.10.002
- Stachon A, 2005, SHOCK, V24, P34, DOI 10.1097/01.shk.0000164693.11649.91
- Stachon A, 2004, CLIN CHEM LAB MED, V42, P933, DOI 10.1515/CCLM.2004.151
- Stachon A, 2007, CRIT CARE, V11, DOI 10.1186/cc5932
- Vincent JL, 1996, INTENS CARE MED, V22, P707, DOI 10.1007/BF01709751