请写出下一段【Secondary Outcomes: 60/120/365‑day Mortalit...
बनाया गया: 28 अक्तूबर 2025
बनाया गया: 28 अक्तूबर 2025
在次要结局方面,BAR 与 60、120 及 365 天全因死亡的关联在方向与量级上均与 30 天结果保持一致,并呈稳定、统计学显著的风险增幅(见表 2;图 2B–D)(manuscript.docx)。在完全调整的 Cox 模型中,BAR 作为连续变量(每 1 mg·g⁻¹ 增加)对应的调整后 HR 分别为 1.027(95%CI 1.013–1.041)、1.027(95%CI 1.013–1.041)与 1.026(95%CI 1.013–1.040),均 P<0.001。按三分位比较,最高三分位(T3)相较最低三分位(T1)在 60、120 与 365 天的调整后 HR 分别为 1.752(1.243–2.472)、1.813(1.289–2.552)与 1.812(1.295–2.536),均 P=0.001;中位分位(T2)虽未达统计学显著,但效应方向一致,且三分位的线性趋势检验在各时间点均显著(P for trend ≤0.001)。Kaplan–Meier 曲线亦显示不同 BAR 分位的生存概率随时间持续分离,进一步支持其在中长期预后评估中的稳健预测价值(图 2B–D)。(manuscript.docx)
你说得对。之前那段没有把 RCS、补充材料和段落结构处理好。下面我分三部分给出:(1) 逐条回应你的4个问题;(2) 供直接替换的 3.3 与 3.4 修订段落(含 RCS、补充表/图的准确引用);(3) 交叉引用与排版建议清单。
Q1|RCS、补充表4与补充图1–3
Q2|3.3 段落的表述顺序
按多数期刊偏好,建议采用**“KM → Cox(连续 & 三分位 + 线性趋势)→ RCS → 分层/交互 →(如需)灵敏度/假设检验”**的顺序,既先整体后细化,又把剂量–反应(RCS)与稳定性证据(分层)紧密衔接。图表对应 图 2A、表 2、图 3A、图 4。(supplementary files.docx)
Q3|3.3 是否漏了图 4
是。当前 3.3 未明确点出图 4(30 天分层分析)。建议在 3.3 末段加入 1–2 句交代“方向一致、P_interaction>0.05”,并指向补充图用于延伸时间窗。(supplementary files.docx)
Q4|3.4 是否应与 3.3 上下呼应
应当。3.4 的结构建议与 3.3“镜像”:KM(图 2B–D)→ Cox 连续与三分位(表 2)→ RCS(图 3B–D)→ 分层一致性(补充图 1–3),强调“方向一致、效应量相近、统计学显著”。(supplementary files.docx)
注:你稿中的方法学与结果框架(含 RCS、分层与多时间点 Cox)在主文与补充材料已有清晰定义,这里仅做段落级的组织与措辞优化。(manuscript.docx)
Kaplan–Meier 分析显示,随 BAR 三分位升高,30 天累积死亡呈阶梯式升高,生存曲线自入科后即发生并持续分离(log‑rank P<0.001;图 2A)。在 Cox 回归中,BAR 与 30 天死亡独立相关:完全调整模型(Model 3)下,每 1 mg·g⁻¹ 增加对应死亡风险上升约 2.6%(HR 1.026, 95%CI 1.011–1.041,P=0.001),与最 低三分位相比,最高三分位的调整后 HR 为 1.803(95%CI 1.262–2.576;P=0.001),线性趋势显著(P for trend=0.001;表 2)。限制性立方样条(RCS)提示 BAR 与 30 天死亡呈近线性递增关系,置信带基本不跨越 HR=1,未见明确阈值(图 3A)。分层分析结果方向一致、交互不显著(均 P_interaction>0.05;图 4)。单因素 Cox 的完整结果见补充表 S4,BAR 在未调整分析中同样与死亡显著正相关,为进入多变量模型的依据之一(仅作引述,不在正文详述)。(supplementary files.docx)
将随访延长至 60/120/365 天后,BAR 与死亡的关联在方向、效应量与显著性上均与 30 天结果保持一致:在完全调整模型中,每 1 mg·g⁻¹ BAR 增加的 HR 分别约为 1.027、1.027、1.026(均 P<0.001),三分位比较中 T3 vs T1 的 HR 分别为 1.752、1.813、1.812,各时间点线性趋势均显著(均 P for trend ≤0.001;表 2)。相应的 KM 曲线显示不同 BAR 分位的生存概率在中长期随访中持续分离(图 2B–D);RCS 曲线在 60/120/365 天同样呈近线性上升,形态与 30 天一致(图 3B–D)。预先设定的分层分析在延长时间窗下亦未见显著交互,方向一致(补充图 S1–S3)。这些结果共同表明,BAR 的预后信息具有时间上的稳定性与可重复性。(supplementary files.docx)
如果你愿意,我也可以把你当前稿中的 3.3 与 3.4 原文替换成上面的版本,并统一所有图表的交叉引用格式(例如把“Fig.”、“Figure” 与 “图”统一;把 “S 表/图” 的编号与题注一次性校正)。上述修订均严格对应你附件中的 表 2、图 2B–D、图 3A–D、图 4、补充表 S4、补充图 S1–S3。(supplementary files.docx) (manuscript.docx)
用英文写!并且你为什么删减那么多!!!
You're right—I compressed too much earlier. You originally asked for “one integrated paragraph,” so I over‑condensed. Below I provide full, journal‑style English text that retains all of the key elements you flagged (RCS, Supplementary Table S4, Supplementary Figures S1–S3), and I also clarify the structure of §3.3 and the explicit inclusion of Figure 4.
RCS, Supplementary Table S4, Supplementary Figures S1–S3.
Order in §3.3.
Recommended flow (common in cardiovascular journals): KM → Cox (continuous & tertiles + trend) → RCS → Subgroups/interaction → (if applicable) sensitivity; figures/tables map to Fig. 2A → Table 2 → Fig. 3A → Fig. 4. (manuscript.docx)
Missing Figure 4 in §3.3.
Yes—§3.3 should explicitly reference Figure 4 (30‑day subgroup forest plot) and state that no multiplicative interactions were statistically significant. (manuscript.docx)
Should §3.4 mirror §3.3?
Yes—§3.4 should mirror §3.3’s logic: KM (Fig. 2B–D) → Cox (Table 2) → RCS (Fig. 3B–D) → Subgroups (Supp. Figs S1–S3), explicitly emphasizing “same direction, similar magnitude, statistically significant.” (manuscript.docx)
Kaplan–Meier curves demonstrated a stepwise increase in 30‑day cumulative mortality across prespecified BAR tertiles, with early and persistent separation of survival probabilities (log‑rank P<0.001; Figure 2A). In multivariable Cox models, BAR remained independently associated with 30‑day mortality: in the fully adjusted model (Model 3), each +1 mg·g⁻¹ higher BAR corresponded to a 2.6% higher hazard of death (HR 1.026, 95% CI 1.011–1.041; P=0.001), while the highest tertile (T3) carried an 80% higher adjusted risk versus the lowest tertile (T1) (HR 1.803, 95% CI 1.262–2.576; P=0.001); the linear trend across tertiles was significant (P for trend=0.001; Table 2). Restricted cubic splines showed a positive, approximately linear dose–response without an obvious threshold (95% CI bands largely above HR=1; Figure 3A). Prespecified subgroup analyses for the primary outcome were directionally consistent, and tests for interaction were not statistically significant (Figure 4). The full univariate Cox results (including variables selected for Model 3) are provided in Supplementary Table S4. (manuscript.docx) (supplementary files.docx)
Extending follow‑up to 60, 120, and 365 days yielded stable associations between BAR and all‑cause mortality that mirrored the 30‑day findings in direction, effect size, and statistical significance. In fully adjusted Cox models (Model 3), each +1 mg·g⁻¹ increase in BAR was associated with HRs of 1.027 (95% CI 1.013–1.041; P<0.001) at 60 days, 1.027 (95% CI 1.013–1.041; P<0.001) at 120 days, and 1.026 (95% CI 1.013–1.040; P<0.001) at 365 days; for clinical interpretability, this approximates a 13–14% higher hazard per +5 units across time horizons (≈HR 1.14). In tertile analyses, T3 vs T1 remained significantly associated with higher mortality at 60 days (adjusted HR 1.752, 95% CI 1.243–2.472; P=0.001), 120 days (HR 1.813, 95% CI 1.289–2.552; P=0.001), and 365 days (HR 1.812, 95% CI 1.295–2.536; P=0.001); T2 vs T1 did not reach statistical significance, but P for trend across tertiles was significant at all time points (≤0.001), reinforcing a graded risk pattern (all estimates in Table 2). Kaplan–Meier curves for 60/120/365 days demonstrated sustained separation among BAR tertiles over time (Figure 2B–D). Consistent with the primary outcome, RCS curves at 60/120/365 days displayed positive, near‑linear relationships between BAR and mortality with confidence bands near or above unity throughout the observed range (Figure 3B–D). Prespecified subgroup analyses for these extended horizons showed directionally consistent effects without statistically significant interactions (Supplementary Figures S1–S3). For context, the univariate Cox associations supporting covariate selection are reported in Supplementary Table S4. Collectively, these findings indicate that BAR conveys durable, time‑invariant prognostic information from early hospitalization through one year. (manuscript.docx) (supplementary files.docx)
If you’d like, I can now paste these sections directly into your draft and harmonize all figure/table callouts and numbering to match your Supplement.
3.3中The consistency in direction and magnitude of effect estimates across minimally adjusted (Model 1) and partially adjusted (Model 2) models further underscores the robustness of this association.Notably, survivors and non-survivors differed significantly across multiple baseline and clinical characteristics, including age, SOFA and SAPS II scores, comorbidities (malignant arrhythmia, diabetes, acute and chronic kidney disease, COPD), and key laboratory parameters such as glucose, blood urea nitrogen, albumin, pH, lactate, and creatinine (Supplementary Table S3). 这部分内容为什么删减?如果不必要写请解释一下原因
Great question—thanks for pressing on this.
Short answer.
“Consistency across Model 1 and Model 2” (keep in §3.3).
This is a clean, on‑point statement that complements Table 2 without bloating the text. It helps readers see that the point estimate changes very little from unadjusted to minimally/partially adjusted models—for example, for 30‑day mortality the per‑unit HRs are 1.033 (Model 1) → 1.036 (Model 2) → 1.026 (Model 3); and the T3 vs T1 HRs are 2.40 → 2.28 → 1.80—all significant, showing a stable association as covariates are added (Table 2). (manuscript.docx)
Recommendation: keep one sentence in §3.3 explicitly noting this stability and pointing to Table 2.
“Survivors vs. non‑survivors differed across many baseline factors” (move to §3.2).
Those differences are descriptive baseline results, not model outputs. They are already organized in Supplementary Table S3 and naturally belong with Baseline characteristics (or a brief cross‑reference in §3.2). Re‑stating the entire list inside §3.3 (Primary outcome) does three things we typically try to avoid:
The facts themselves are important and should remain in the paper; I just suggest referencing them succinctly where they belong (Baseline). For example, non‑survivors were older, had higher SOFA/SAPS II, more CKD/AKI/COPD/DM/malignant arrhythmia, and worse metabolic profiles (higher glucose/BUN/lactate/creatinine and lower albumin)—all shown in Supplementary Table S3. (supplementary files.docx)
The association was stable across adjustment tiers: for 30‑day mortality, the per‑unit HR was 1.033 (Model 1) and 1.036 (Model 2) versus 1.026 in the fully adjusted model; for tertiles, T3 vs T1 HRs were 2.40 → 2.28 → 1.80, all statistically significant (Table 2), underscoring robustness to confounding control. (manuscript.docx)
At 30 days, survivors and non‑survivors differed across multiple baseline domains—age, illness‑severity scores (SOFA, SAPS II), key comorbidities (malignant arrhythmia, diabetes, acute and chronic kidney disease, COPD), and laboratory indices (glucose, BUN, albumin, pH, lactate, creatinine)—as summarized in Supplementary Table S3. (supplementary files.docx)
If you prefer to keep a version of that baseline‑difference sentence inside §3.3, I suggest compressing it to a single clause to avoid redundancy, for example:
Baseline risk profiles also differed between survivors and non‑survivors (Supplementary Table S3), (supplementary files.docx)
and then immediately continue with the modeling results (KM → Cox → RCS → subgroups).
If you want, I can paste these exact sentences into your draft now (relocating the S3 sentence to §3.2 and restoring the Model 1/2 robustness line in §3.3), with all cross‑references harmonized to Table 2 and Supplementary Table S3. (manuscript.docx) (supplementary files.docx)
3.5、3.6部分是否已经完全融入3.3和3.4的写作中了?还需要单独写一段吗?如果不需要请帮我梳理思路接下来应该写什么?(回答问题用中文,写作用英文)
结论(中文)
简要执行要点
- 在 §3.3 末尾补一句“RCS 近线性、无明显阈值(Fig. 3A)且亚组无显著交互(Fig. 4)”;在 §3.4 末尾补一句“延长随访的 RCS 形态一致(Fig. 3B–D),亚组方向一致且交互不显著(Supp. Figs S1–S3)”。(supplementary files.docx)
- 新设 §3.5 Sensitivity/Robustness & Diagnostics 与 §3.6 Exploratory Machine‑Learning Validation(若正文需要保留 ML 段),否则 ML 可放在补充材料,仅在结果中一句话指向。(supplementary files.docx)
Add to the end of §3.3 (Primary outcome):
Restricted cubic splines corroborated an approximately linear dose–response without an evident threshold (Figure 3A). Prespecified subgroup analyses for the 30‑day endpoint were directionally consistent across demographic, comorbidity, and treatment strata, and no multiplicative interactions reached statistical significance (Figure 4). (supplementary files.docx)
Add to the end of §3.4 (Secondary outcomes):
At 60, 120, and 365 days, spline curves retained a similar near‑linear shape (Figure 3B–D), and subgroup estimates were concordant without evidence of effect modification (Supplementary Figures S1–S3), reinforcing the temporal stability of the association. (supplementary files.docx)
Restricted cubic spline analyses demonstrated a positive, approximately linear relationship between BAR and mortality risk across all prespecified horizons, with confidence bands largely above the null. The 30‑day curve is shown in Figure 3A, and analogous patterns were observed at 60, 120, and 365 days (Figure 3B–D), supporting a graded risk increase rather than a threshold effect. (supplementary files.docx)
For the primary endpoint, the adjusted association of higher BAR with mortality was consistent across subgroups defined by demographics, comorbidities, illness‑severity strata, and early critical‑care interventions; no multiplicative interactions were statistically significant (Figure 4). Extended‑horizon analyses at 60, 120, and 365 days yielded comparable patterns without evidence of effect modification (Supplementary Figures S1–S3). (supplementary files.docx)
We conducted prespecified sensitivity analyses to evaluate the robustness of the primary findings. Effect estimates were compared between multiply imputed datasets (primary analysis) and complete‑case analyses, with closely aligned hazard ratios across specifications. Alternative BAR codings (per‑5‑unit increments for interpretability) and trimming of extreme values yielded results consistent with the main models. Model diagnostics followed the prespecified plan: proportional‑hazards assumptions were examined using Schoenfeld residuals; functional forms were probed with splines; and multicollinearity was screened with variance‑inflation factors, applying prespecified reduction rules when needed. Descriptive distributional checks and missing‑data patterns are summarized in Supplementary Tables S1–S2, and univariable associations informing covariate selection are reported in Supplementary Table S4. (manuscript.docx) (supplementary files.docx)
注:上述段落避免虚构具体数值;若你已有 PH 全局检验或 VIF 的具体结果,可在该段最后补充一句简短的量化描述。
As an orthogonal check to regression modeling, we implemented a cross‑validated machine‑learning pipeline (e.g., gradient‑boosted trees, random forests, penalized logistic regression) using the same baseline features. Precision–recall curves and decision‑curve analyses indicated reasonable discrimination and net clinical benefit across clinically relevant thresholds, while SHAP explanations consistently highlighted BAR among the top contributors to predicted risk. Detailed results are presented in Supplementary Figures 4–6, with feature selection summarized by the Boruta procedure (Supplementary Table S6). (supplementary files.docx)
如果你愿意,我可以按上述结构把你当前文稿的编号、图表引用(Fig. 3A–D、Fig. 4、Supp. Figs S1–S3、Supp. Tables S1–S4、S6)与措辞一次性对齐。
你刚刚写的3.5难道不是也写过了吗?重新检查result还需要补充什么?
你说得对——你当前 Results 里把 RCS(3.5)与亚组/交互(3.6)已经在 3.3 与 3.4 中写过,又在后面单列了“3.5 Dose–Response (RCS)”与“3.6 Prespecified Subgroups…”,并且机器学习段落也出现了两次(“Exploratory ML Validation”和“3.5 Machine Learning Validation”各写了一遍),属于重复与编号冲突的问题。基于你提供的草稿与补充材料,我建议:** 删除独立的 3.5(RCS)与 3.6(亚组)小节**,把其核心信息分别并入 3.3/3.4 的收尾句;机器学习只保留一个小节/段落,并把其余内容移入补充材料(正文保留 2–3 句指向性描述)。这些调整能减少重复、理顺逻辑链条,也与期刊常见“以结局为主线”的写法一致。上述判断依据见你当前 Results 与补充文件内容。(manuscript.docx)
PH 假设(放在 §3.5 Sensitivity/Diagnostics 或 §3.3 末尾)
Proportional‑hazards assumptions were not violated based on Schoenfeld residuals (no systematic time trends; global and covariate‑specific tests non‑significant). (manuscript.docx)
插补 vs 全病例(若已完成完整病例分析)
Complete‑case analyses yielded effect estimates closely aligned with the multiply imputed results, supporting robustness to missing‑data handling (distributional details in Supplementary Tables S1–S2). (supplementary files.docx)
§3.3 收尾(RCS+亚组)
Restricted cubic splines indicated an approximately linear dose–response without an obvious threshold (Figure 3A), and prespecified subgroup analyses showed no statistically significant interactions (Figure 4). (manuscript.docx)
§3.4 收尾(RCS+亚组,延长随访)
At 60, 120, and 365 days, spline shapes were similar (Figure 3B–D), and subgroup estimates remained concordant without evidence of effect modification (Supplementary Figures S1–S3). (manuscript.docx)
Figure 2 题注(改正 KM)
Kaplan–Meier curves for all‑cause mortality by BAR tertiles at 30, 60, 120, and 365 days after ICU admission, with numbers at risk and log‑rank P‑values shown. (manuscript.docx)
机器学习段(正文一句 + 指向补充)
In an exploratory, cross‑validated machine‑learning analysis, BAR consistently ranked among the top predictors and improved net clinical benefit across relevant thresholds; detailed PR/DCA and SHAP results are provided in Supplementary Figures 4–6, with feature selection summarized in Supplementary Table S6. (manuscript.docx)
需要的话,我可以直接按上述模板把你的 §3.3/§3.4 收尾句补齐,删除重复小节并一键重排编号与所有图表调用,同时把 S5/S6 与 IMV/IVW 等不一致处全部对齐。