Acta medica Iranica · 2012
Multi organ failure following intravenous gasoline for suicide: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Zhao Jinxi, Wang Xiaohong, Xie Ruiheng, Juhou Quxin, Wang Dongqing, Shi Xiaomin, Zhang Wei, Shi Lei, Peng Yan, Tang Xiaowei
Аннотация
OBJECTIVES: Gastrointestinal (GI) bleeding is a serious complication of immunoglobulin A vasculitis (IgAV), but reliable predictors are still lacking. This study aimed to identify clinical risk factors and develop a prediction model for IgAV-related GI bleeding in a large patient cohort.
METHODS: In this retrospective study, 968 patients with IgAV from the Affiliated Hospital of Southwest Medical University (2019-2024) were divided into GI bleeding (n=484) and non-bleeding (n=484) groups. We analysed seasonal onset patterns and used multivariate logistic regression with ROC curve validation to identify predictors.
RESULTS: This retrospective study revealed that summer-onset disease was associated with a significantly higher risk of GI bleeding compared to other seasons (OR=1.67, 95% CI:1.15-2.45; p=0.007), representing a 13.8% absolute risk increase (p<0.001). The neutrophil-to-albumin ratio (NAR) was the strongest biochemical predictor (OR=1.79; 95% CI:1.33-2.47; AUC=0.723). High systemic immune-inflammation index levels also increased risk (OR=2.91, 95% CI:1.67-5.08), while mean platelet volume (MPV) was protective (OR=0.78, 95% CI:0.68-0.90). A combined model including seasonality, NAR, and MPV showed superior predictive performance (AUC=0.742, 95% CI:0.711-0.772).
CONCLUSIONS: Summer onset, elevated NAR, and decreased MPV help identify IgAV patients at high risk of GI bleeding. A model combining these factors allows effective risk stratification and supports targeted monitoring in clinical practice, particularly for summer-admitted patients with high neutrophil-to-albumin ratios.
METHODS: In this retrospective study, 968 patients with IgAV from the Affiliated Hospital of Southwest Medical University (2019-2024) were divided into GI bleeding (n=484) and non-bleeding (n=484) groups. We analysed seasonal onset patterns and used multivariate logistic regression with ROC curve validation to identify predictors.
RESULTS: This retrospective study revealed that summer-onset disease was associated with a significantly higher risk of GI bleeding compared to other seasons (OR=1.67, 95% CI:1.15-2.45; p=0.007), representing a 13.8% absolute risk increase (p<0.001). The neutrophil-to-albumin ratio (NAR) was the strongest biochemical predictor (OR=1.79; 95% CI:1.33-2.47; AUC=0.723). High systemic immune-inflammation index levels also increased risk (OR=2.91, 95% CI:1.67-5.08), while mean platelet volume (MPV) was protective (OR=0.78, 95% CI:0.68-0.90). A combined model including seasonality, NAR, and MPV showed superior predictive performance (AUC=0.742, 95% CI:0.711-0.772).
CONCLUSIONS: Summer onset, elevated NAR, and decreased MPV help identify IgAV patients at high risk of GI bleeding. A model combining these factors allows effective risk stratification and supports targeted monitoring in clinical practice, particularly for summer-admitted patients with high neutrophil-to-albumin ratios.