在资源有限的环境中,急性损伤的原因,并发症和短期结果
Nalaka Herath1, Shamila De Silva2, Prasitha Liyanage1
1Department of Nephrology, Colombo North Teaching Hospital, Ragama, Sri Lanka.
International journal of nephrology
|January 1, 2025
概括
急性损伤 (AKI) 的结果因病因和患者因素而异. 老年患者和那些患有并发症的人面临严重AKI,慢性病和死亡的更高风险,强调了早期检测和干预的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 急性损伤 (AKI) 是一个重大的临床挑战,其结果受到潜在原因,患者特定因素和护理质量的影响.
- 了解AKI在不同医疗机构的流行病学和结果对于改善患者管理至关重要.
研究的目的:
- 在斯里兰卡的第三级转诊中心调查急性损伤 (AKI) 患者的原因,并发症和90天的结果.
- 为了确定与AKI严重程度,进展和死亡率相关的风险因素.
主要方法:
- 对464名患有AKI的成年患者进行了回顾性分析,并将其转诊给脏病学服务.
- 使用病:改善全球结果 (KDIGO) 标准对AKI严重程度进行了分类.
- 从医院和诊所记录中收集数据,包括患者人口统计数据,并发症,AKI原因以及出院时的功能和3个月的随访.
主要成果:
- 大多数患者 (45.69%) 退院时功能正常,37.28%的功能受损,17.03%的患者在住院期间死亡.
- 在3个月的随访时,87.8%的患者功能正常化,但10.6%的患者没有完全恢复,1.6%的患者死亡.
- 在60岁以上的患者中,慢性病或死亡的进展显著更高 (p=0.017). 严重的AKI与2型糖尿病 (p=0.0042),高血压 (p < 0.0001) 和多种并发病 (p=0.0014) 有关.
- 死亡率在第三阶段AKI (22%) 显著高于第一阶段和第二阶段 (11%). 产前原因与较低的死亡率相关 (OR:0.59,95% CI:0.35-0.99,p=0.047).
结论:
- 老年患者和伴随疾病患者的急性损伤与大量的发病率和死亡率有关.
- 早期识别高风险个体对于AKI预防,及时诊断和有效治疗至关重要.
- 斯里兰卡的挑战包括基础设施,人力,研究和数据记录的局限性,影响最佳AKI护理.
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