患有蛋白尿症的住院儿童的急性损伤:多中心回顾性分析
Katelyn H Baggett1, Tomas Manghi2, Vonn Walter3
1Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States of America.
PloS one
|March 21, 2024
概括
在护理的第一天住院儿童的蛋白尿与急性损伤 (AKI) 的更高风险,需要置换疗法,休克,抗生素使用和30天死亡率有关.
科学领域:
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
- 临床结果研究研究
背景情况:
- 急性损伤 (AKI) 是住院儿童的一个重大问题.
- 以前的成年人研究表明蛋白尿症表明AKI和不良结果.
- 儿科AKI中早期发病蛋白尿的预测价值需要进一步调查.
研究的目的:
- 确定医院第一天的蛋白尿是否与儿科患者的AKI有关.
- 评估早期蛋白尿和重症监护结果之间的关联,包括替代疗法,休克,抗生素使用和30天死亡率.
- 假设早期蛋白尿与住院儿童不良临床结果之间的联系.
主要方法:
- 使用TrinetX电子健康记录进行的回顾性队列研究.
- 纳入标准:小儿病患者 (2-18岁) 尿液分析,3天的医院/重症监护账单和肌素值;不包括先前存在的脏疾病.
- 基于病的AKI定义:改善全球结果 (KDIGO) 修改的标准;相关临床结果的评估.
主要成果:
- 这项研究包括971名儿科患者,其中44.7%的患者表现出蛋白尿.
- 蛋白尿与更高AKI严重性 (OR 2.41),需要脏替代疗法 (OR 4.58) 的增加几率,冲击/抗生素使用 (OR 1.34) 和30天死亡率 (OR 10.0) 的增加相关.
- 针对AKI严重程度,脏替代疗法,休克/抗生素使用和死亡率发现了显著的关联.
结论:
- 住院儿童早期蛋白尿是严重AKI风险增加的潜在指标.
- 蛋白尿可能预测需要替代疗法,休克,抗生素使用和30天死亡率.
- 在早期蛋白尿和重症监护服务,机械输管或因诺托普/血管压缩剂使用之间没有发现显著的关联.
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