在患有急性损伤的老年肥胖重症患者中,水分状况和死亡率之间的关联:一项回顾性队列研究

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Jiesheng Yang¹, Junhua Yang¹

¹Department of Nephrology, Pu'er People's Hospital, Pu'er, China.

Science progress

|January 6, 2026

概括

过多的液体会显著增加老年肥胖患者急性损伤 (AKI) 的90天死亡率. 这凸显了这种脆弱人群中谨慎流体管理的关键需求.

科学领域:

关键护理医学关键护理医学
腎臟病學 (nephrology) 是一種醫學專業.
老年病的医生老年病的医生
肥胖医学肥胖医学

背景情况:

在重症肥胖患者中,流体管理存在独特的挑战,原因是改变了生理学和标准配方的局限性.
肥胖症在重症监护中越来越令人担忧,影响患者的治疗结果和治疗策略.
急性损伤 (AKI) 是重症患者,特别是老年人和肥胖患者的常见并发症,需要精确监测液体平衡.

研究的目的:

调查老年肥胖重症患者诊断为AKI的液体过载和90天死亡率之间的关联.
为了确定这一特定患者队列中死亡的风险因素.
为老年肥胖AKI患者的流体管理策略提供临床实践的信息.

主要方法:

对2020年1月至2022年12月期间入院的患有AKI的老年肥胖重症患者进行回顾性队列研究.
基于病的AKI诊断:改善全球结果 (KDIGO) 标准.
液体过载被定义为>10%的体重调整后的液体平衡;主要结果是使用卡普兰-梅尔曲线和考克斯回归分析的90天全因死亡率.

主要成果:

总共包括539名患者;45.3%的人经历过多的液体负荷.
流体过载与90天死亡率显著增加有关 (50.4%与29.2%,P <0.01).
多变量分析确定了流体过载 (HR=2.04) 和SOFA得分 (HR=1.13) 作为死亡率的独立预测因素.

结论:

流体过载是老年肥胖重症患者90天死亡率增加的重要独立预测因素.
这些发现强调了在这种高风险人群中保持警地监测和管理流体状况的重要性.
优化流体管理可能对改善老年肥胖AKI患者的生存结果至关重要.

关键词:

急性损伤是什么?急性损伤是什么?年长的老人老年人老年人.流体过载是因为流体过载.死亡率死亡率肥胖肥胖肥胖肥胖肥胖肥胖肥胖肥胖

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