De Ritis Ratio to Predict Clinical Outcomes of Intermediate- and High-Risk Pulmonary Embolisms

被引:2
作者
Durak, Koray [1 ]
Nubbemeyer, Katharina [1 ]
Zayat, Rashad [1 ]
Spillner, Jan [1 ]
Dineva, Slavena [1 ]
Kalverkamp, Sebastian [1 ]
Kersten, Alexander [2 ]
机构
[1] RWTH Univ Hosp, Fac Med, Dept Thorac Surg, D-52074 Aachen, Germany
[2] RWTH Univ Hosp, Fac Med, Dept Cardiol Pneumol Angiol & Intens Care, D-52074 Aachen, Germany
关键词
pulmonary embolism; transaminases; liver function; intensive care medicine; heart failure; shock; lung emboly; De Ritis; DYSFUNCTION;
D O I
10.3390/jcm13072104
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Abnormal liver function tests can identify severe cardiopulmonary failure. The aspartate transaminase/alanine transaminase (AST/ALT) ratio, or the De Ritis ratio, is commonly used to evaluate acute liver damage. However, its prognostic value in pulmonary embolism (PE) is unknown. Methods: Two cohorts, including patients with intermediate- and high-risk PEs, were established: one with an abnormal baseline AST/ALT ratio (>1) and another with a normal baseline AST/ALT ratio (<1). The primary outcome was a 60-day mortality. Secondary outcomes included peak N-terminal pro-brain-natriuretic-peptide (NT-proBNP) levels, complications, and the need for critical care treatment. To assess the effect of abnormal AST/ALT ratios, inverse probability weighted (IPW) analyses were performed. Results: In total, 230 patients were included in the analysis, and 52 (23%) had an abnormal AST/ALT ratio. After the IPW correction, patients with an abnormal AST/ALT ratio had a significantly higher mortality rate and peak NT-proBNP levels. The relative risks of 60-day mortality, shock development, use of inotropes/vasopressors, mechanical ventilation, and extracorporeal life support were 9.2 (95% confidence interval: 3.3-25.3), 10.1 (4.3-24), 2.7 (1.4-5.2), 2.3 (1.4-3.7), and 5.7 (1.4-23.1), respectively. Conclusions: The baseline AST/ALT ratio can be a predictor of shock, multiorgan failure, and mortality in patients with a pulmonary embolism.
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页数:12
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