危急病患者1期急性损伤后的长期死亡率 - 一项观察性队列研究
Carmen A Pfortmueller1, Markus Hahn1, Angela Eggimann1
1Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Journal of critical care
|May 30, 2025
概括
在重症监护室的1级急性损伤 (AKI) 与一年死亡率的增加有关. 即使是轻微的损伤的早期诊断对于患者的结果至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 急性损伤 (AKI) 在重症监护室 (ICU) 很常见,并与较高的死亡率有关.
- 病:改善全球结果 (KDIGO) 准则使用血清肌素和尿液输出来对AKI进行分类.
- 第1阶段AKI的预后价值,特别是基于肌素标准的预后价值,尚未得到充分确立.
研究的目的:
- 调查KDIGO肌素标准定义的第1阶段AKI与成年ICU患者的一年死亡率之间的关联.
- 确定在ICU环境中早期的AKI是否具有预后意义.
- 评估第一阶段AKI对在ICU和医院逗留时间的影响.
主要方法:
- 来自两个三级保健中心的成年ICU患者的回顾性队列分析 (2013-2021年).
- 第1阶段AKI是使用KDIGO肌素标准在ICU入院后的前七天内定义的.
- 使用多变量回归模型来评估与一年死亡率的关联,经过调整以考虑混因素.
主要成果:
- 在42,446名患者中,有11%的人患上1期AKI.
- 第1阶段的AKI与一年死亡率的增加显著相关 (OR 1.6).
- 第1阶段的AKI也与更长的ICU (β 1.4) 和住院时间 (β 2.7) 相相关.
结论:
- 1期AKI,即使有轻微的肌素升高,也是成年ICU患者一年死亡率的重要预测因素.
- 这些发现强调了亚临床损伤的预后重要性.
- 需要加大努力来诊断和管理AKI的整个频谱.
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