急性损伤预测了非常老的重症患者的死亡率
Elisa Alba Schmidt1, Silvia De Rosa2, Jakob Müller3
1III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Hamburg Center for Kidney Health (HCKH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
European journal of internal medicine
|May 15, 2024
概括
急性损伤 (AKI) 在严重病情的老年患者 (≥90岁) 中很常见,增加死亡风险. 肌素监测对于预测这种脆弱人群的结果至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年病的医生 老年病的医生
- 关键护理医学 关键护理医学
背景情况:
- 越来越多的老年患者进入ICU需要了解急性损伤 (AKI) 的风险.
- 在90岁以上的患者中,关于AKI发生率和结局的数据有限.
- 这项研究重点关注90岁及以上重症患者的AKI.
研究的目的:
- 对年龄≥90岁的重症患者中AKI的发病率进行调查.
- 为了确定与AKI相关的结果在这个老年人群中.
- 评估不同AKI定义的预测值.
主要方法:
- 德国大学医学中心的回顾性队列研究 (2008-2020年).
- 基于病:改善全球结果 (KDIGO) 标准 (肌素和/或尿液输出) 的AKI定义.
- 主要终点:整体1年死亡率;次要终点:住院死亡率,ICU和住院时间.
主要成果:
- 在1054名年龄≥90岁的合格患者中,AKI发生在24.4%的患者中.
- AKI独立地与总死亡率 (HR 1.21) 和住院死亡率 (OR 2) 的增加有关.
- AKI显著延长了ICU和住院时间;基于肌素的AKI定义显示出比基于尿液的标准更好的死亡率预测.
结论:
- AKI是非常老年ICU患者的常见并发症.
- 任何AKI阶段都与死亡风险增加有关.
- 肌素动态对于AKI评估和这一人口群中的死亡率预测至关重要.
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