手术后急性损伤与持续的功能障碍有关:一个多中心倾向匹配队列研究
Blaine Stannard1, Richard H Epstein2, Eilon Gabel3
1Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
BJA open
|March 25, 2025
概括
手术后急性损伤 (pAKI) 显著增加了长期功能下降的风险. 这项研究发现,pAKI与手术后36个月内膜过率降低40%的风险相关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
- 关键护理医学 关键护理医学
背景情况:
- 术后急性损伤 (pAKI) 的长期功能后果仍然不完全理解.
- 确定 pAKI 后持续性功能减弱的风险对于患者管理至关重要.
研究的目的:
- 为了确定患有pAKI的患者长期功能下降的程度是否比没有pAKI的患者更大.
- 量化pAKI与持续降低膜过率 (GFR) 之间的关联.
主要方法:
- 一项多中心的回顾性研究分析了来自三个三级医院的95,213名成年患者的数据.
- 患者的倾向性得分被匹配并根据pAKI的发生进行分层,根据急性损伤网络分类来定义.
- 评估的主要结局是随访GFR比基线下降40%,评估时间超过036个月后释放使用分片Cox模型.
主要成果:
- 在整个研究人群中,pAKI的发病率从9.9%到13.7%不等.
- pAKI与40%的GFR下降的风险增加显著相关.
- 40%的GFR下降的危险比率从13.35 (0-6个月) 到4.32 (24-36个月) 之间,所有这些都是P<0.001.
结论:
- 术后急性损伤与40%的GFR下降的风险大幅增加有关.
- 这种增加的风险在手术后的36个月内仍然存在.
- 这些发现强调了监测患有pAKI的患者功能的重要性.
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