65岁及以上成年人接受连续脏替代疗法的年龄分层死亡率和相关风险因素:一个连续的回顾性研究
Seong-Wook Lee1, Yu Jin Seo2, Jeong-Hoon Lim1
1Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944, South Korea.
BMC nephrology
|November 19, 2025
概括
在65岁以上接受连续脏替代疗法 (CKRT) 的成年人中,晚年并没有增加死亡风险. 基线健康和营养状况影响了老年CKRT患者的结果,这表明仅仅年龄不应该指导治疗决策.
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:
- 预期寿命的增加导致65岁及以上的成年人需要持续置换疗法 (CKRT).
- 目前的做法往往将老年人 (≥65岁) 分类为单一的CKRT类别,可能会掩盖特定年龄的死亡风险.
- 需要精确的年龄分层来准确了解CKRT患者的年龄相关死亡率.
研究的目的:
- 调查特定年龄组 (65-74岁,75-84岁,≥85岁) 与接受CKRT的成年人死亡风险之间的联系.
- 确定与接受急性损伤 (AKI) 中CKRT的老年人年龄特定死亡率相关的因素.
主要方法:
- 对2017年8月至2024年3月期间接受AKICKRT的1017名成年人 (≥65岁) 的回顾性分析.
- 患者分为三个年龄组:65-74岁,75-84岁和≥85岁.
- 使用后勤回归来评估年龄分层对48小时,7天和住院死亡率的影响,并确定每个年龄组内的死亡率预测因素.
主要成果:
- 整体死亡率在48小时内为28.7%,在7天内为39.5%,在住院期间为59.7%.
- 在对临床变量进行调整后,75-84岁和≥85岁的患者与65-74岁年龄组相比,死亡风险没有增加.
- 在75-84岁的患者中,较高的血清白蛋白与较低的住院死亡率 (aOR 0.35) 有关.
- 在85岁以上的患者中,较高的BMI与7天和住院死亡率的降低有关 (aOR分别为0.74和0.65).
结论:
- 仅高级年龄 (≥65岁) 不是接受CKRT的患者早期或住院死亡率增加的预测因素.
- 对于接受CKRT的75岁及以上的患者,基线健康状况和营养状况是死亡率的重要预测因素.
- 年龄不应该是决定AKI老年人CKRT资格的唯一因素.
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