在资源有限的环境中,急性损伤与重症监护室死亡率之间的关联
Sonam J Shah1, Rishita Chamarthi1, Jotham Gondwe2
1University of North Carolina, School of Medicine, Chapel Hill, North Carolina.
The Journal of surgical research
|August 20, 2025
概括
急性损伤 (AKI) 在马拉维显著增加了重症监护室 (ICU) 的死亡率. 早期的AKI识别和管理,特别是在手术患者中,对于改善资源有限的环境中的生存至关重要.
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
- 全球健康 全球健康
背景情况:
- 急性损伤 (AKI) 是一个全球性的健康挑战,不成比例地影响低收入和中等收入国家.
- 撒哈拉以南非洲地区面临高高的AKI相关死亡率,原因是置换疗法和重症监护室 (ICU) 容量有限.
研究的目的:
- 在马拉维的一家三级医院评估AKI和ICU死亡率之间的关联.
- 确定影响AKI重症患者死亡率的因素.
主要方法:
- 马拉维卡穆祖中央医院的493名ICU患者的回顾性分析 (2016-2018).
- 由估计的淋巴膜过率 (eGFR) ≤60mL/min/1.73m2和寡尿症定义的AKI.
- 使用了双变量和多变量逻辑回归分析.
主要成果:
- 整体ICU死亡率为57.2%,其中21.0%的患者患有AKI.
- AKI与较高的死亡率 (79.0%与44.3%,P<0.001) 有显著的关联.
- 多变量分析证实AKI是死亡率的独立预测因子 (aOR5.12),而患有AKI的手术患者的死亡率更高 (aOR9.06).
结论:
- 及时的AKI识别和管理对于改善ICU结果至关重要,特别是在资源有限的环境中.
- 扩大透析接入和重症监护基础设施可以提高在低资源环境中的重症术后患者的存活率.
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