在创伤后急性损伤中,寡尿症的预测因素
William B Risinger1, Samuel J Pera1, Kelsey E Cage1
1Department of Surgery, University of Louisville School of Medicine, Louisville, KY.
Surgery
|November 12, 2023
概括
非寡头性急性损伤在创伤患者中更常见,并且更容易存活. 女性性别,血管压缩剂的使用和液体平衡预测了寡性急性损伤.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 创伤外科 手术 创伤外科
- 临界护理医学 临界护理医学
背景情况:
- 急性损伤 (AKI) 呈现为非寡头性或寡头性变体,非寡头性AKI的发病率和死亡率较低.
- 虽然非寡头性AKI在住院患者中很常见,但其在创伤人群中的发病率和风险因素仍然不清楚.
- 这项研究研究了严重受伤的创伤患者中AKI变异的特征和危险因素.
研究的目的:
- 确定创伤患者中非寡头性 versus寡头性急性损伤的发生率.
- 在这个人群中确定与小性急性损伤发展相关的独特风险因素.
- 在创伤患者中比较非寡头和寡头AKI之间的结果.
主要方法:
- 在2016-2021年期间,对227名创伤重症监护病房患者进行了回顾性分析,诊断出AKI.
- 根据每天的尿量,将AKI病例分为非寡头性 (>400毫升/天尿量) 和寡头性 (<400毫升/天尿量) 的分类.
- 后勤回归分析以确定寡尿症的风险因素,控制各种临床变量.
主要成果:
- 在创伤队列中,非寡头性AKI占所有AKI病例的74%,显示出明显更高的生存率 (78%对35.6%).
- 后勤回归确定了女性的性别,血管压缩剂的使用和48小时后更大的净液体平衡作为寡头性AKI的独立预测因素.
- 即使控制了诸如年龄,冲击指数和毒药物暴露等因素,这些发现仍然是正确的.
结论:
- 非寡头性AKI是创伤后患者中占主导地位的AKI形式,并且与改善的生存结果有关.
- 特定的风险因素,包括女性性别,血管压力剂的使用和正流体平衡,与创伤患者的寡性AKI的发展有独特的关联.
- 了解这些差异可以为创伤护理中的AKI提供有针对性的管理策略.
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