初始分诊生命体征对急性主动脉夹层患者院内死亡率的预测价值：一项急诊科回顾性研究
Predictive value of initial triage vital signs for in-hospital mortality in acute aortic dissection patients: a retrospective study in the emergency department.
摘要(中文译文)
急性主动脉夹层（AAD）是一种危及生命的急症，需要快速诊断和治疗。分诊时获取的生命体征可即时获得，可能为早期风险分层提供有用信息。旨在评估分诊生命体征是否与AAD患者院内死亡率独立相关，并特别关注将心率作为分类变量进行分析以及以临床相关单位分析血压。本研究对2024年1月1日至11月23日期间在中国某三级医院急诊科连续收治的702例AAD患者进行了回顾性队列研究。心率分为心动过缓（<60次/分）、正常（60-100次/分）或心动过速（>100次/分）。血压按每10 mmHg变化进行分析。单因素分析中显著（<0.10）的变量纳入多因素模型。采用受试者工作特征曲线下面积（AUC）结合10折交叉验证评估模型性能。在702例患者中，293例（41.7%）在住院期间死亡。多因素logistic回归确定高龄（校正OR 1.029/岁，95% CI 1.017-1.041）、男性（校正OR 1.495，95% CI 1.036-2.157）、心动过缓（校正OR 2.500，95% CI 1.300-4.800）、心动过速（校正OR 1.800，95% CI 1.100-2.900）、较低体温（校正OR 1.499/体温每降低1 °C，95% CI 1.082-2.075）和较高舒张压（校正OR 1.105/每升高10 mmHg，95% CI 1.001-1.220）为院内死亡的独立危险因素。该模型显示出可接受的区分能力（平均交叉验证AUC 0.71，95% CI 0.68-0.74）。初始分诊生命体征，尤其是心率异常（过低和过高）、较低体温和较高舒张压，是AAD患者院内死亡的独立预测因素。评估这些易于获得的参数可支持急诊科的早期风险分层。
Abstract
Acute aortic dissection (AAD) is a life-threatening emergency requiring rapid diagnosis and treatment. Vital signs obtained at triage are immediately available and may provide useful information for early risk stratification. To evaluate whether triage vital signs are independently associated with in-hospital mortality in patients with AAD, with a specific focus on analyzing heart rate as a categorical variable and blood pressure in clinically relevant units. We performed a retrospective cohort study of 702 consecutive patients with AAD admitted to the emergency department of a tertiary hospital in China between January 1 and November 23, 2024. Heart rate was categorized as bradycardia (<60 bpm), normal (60-100 bpm), or tachycardia (>100 bpm). Blood pressure was analyzed per 10-mmHg change. Variables significant in univariate analysis ( < 0.10) were entered into a multivariate model. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) with 10-fold cross-validation. Among 702 patients, 293 (41.7%) died during hospitalization. Multivariate logistic regression identified older age (adjusted OR 1.029 per year, 95% CI 1.017-1.041), male sex (adjusted OR 1.495, 95% CI 1.036-2.157), bradycardia (adjusted OR 2.500, 95% CI 1.300-4.800), tachycardia (adjusted OR 1.800, 95% CI 1.100-2.900), lower body temperature (adjusted OR 1.499 per 1 °C decrease, 95% CI 1.082-2.075), and higher diastolic blood pressure (adjusted OR 1.105 per 10-mmHg increase, 95% CI 1.001-1.220) as independent risk factors for in-hospital mortality. The model demonstrated acceptable discrimination (mean cross-validated AUC 0.71, 95% CI 0.68-0.74). Initial triage vital signs, particularly deviations in heart rate (both low and high), lower body temperature, and higher diastolic blood pressure, are independent predictors of in-hospital mortality in patients with AAD. Assessing these readily available parameters can support early risk stratification in the emergency department.
如何引用
AMA
Nan Xie, Yixiao Shi. Predictive value of initial triage vital signs for in-hospital mortality in acute aortic dissection patients: a retrospective study in the emergency department.. Frontiers in medicine. 2026; doi:10.3389/fmed.2026.1721657.
APA
Nan Xie, Yixiao Shi (2026). Predictive value of initial triage vital signs for in-hospital mortality in acute aortic dissection patients: a retrospective study in the emergency department.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1721657
GB/T 7714
Nan Xie, Yixiao Shi. Predictive value of initial triage vital signs for in-hospital mortality in acute aortic dissection patients: a retrospective study in the emergency department.[J]. Frontiers in medicine, 2026 doi:10.3389/fmed.2026.1721657.
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