在医疗 ICU 中，急性肾衰竭仍然是高死亡率的预测因素。

Acute renal failure in the medical ICU still predictive of high mortality.

机构信息

Department of Medicine, Stellenbosch University and Tygerberg Academic Hospital, Tygerberg, W Cape.

出版信息

S Afr Med J. 2009 Dec 7;99(12):873-5.

PMID:20459997

Abstract

BACKGROUND

We aimed to determine the outcome and certain predictors of outcome for acute renal failure (ARF) in the medical intensive care unit (ICU) at Tygerberg Hospital.

METHOD

We conducted a retrospective, single-centre cohort study over 12 months comprising all patients admitted to the medical ICU with all causes of renal failure or who developed renal failure following admission to the ICU.

RESULTS

Of 198 medical patients admitted to the ICU, ARF occurred in 46 (23.2%). The leading cause of ARF was acute tubular necrosis. The ICU mortality for ARF patients was 47.8%, compared with 17.5% in ICU patients without ARF. Acute haemodialysis was performed in only 17.3% of the 46 ARF patients. Using Cox proportional hazard regression, we found that mean duration of stay (p<0.001), acute physiology and chronic health evaluation II (Apache II) score (p<0.001), mechanical ventilation (p<0.01), dialysis (p<0.04) and multi-organ failure (p<0.05) affected survival time.

CONCLUSIONS

We found that ARF is still associated with a high mortality rate and longer duration of stay, higher Apache II score, and need for mechanical ventilation; dialysis and presence of multi-organ failure were indicators of a higher mortality rate.

摘要

背景

我们旨在确定蒂尔伯格医院内科重症监护病房（ICU）急性肾衰竭（ARF）的结局和某些结局预测因素。

方法

我们进行了一项为期 12 个月的回顾性单中心队列研究，纳入了所有因各种原因导致肾衰竭或入住 ICU 后发生肾衰竭而入住内科 ICU 的患者。

结果

在 198 名入住 ICU 的内科患者中，发生 ARF 的有 46 例（23.2%）。ARF 的主要病因是急性肾小管坏死。ARF 患者的 ICU 死亡率为 47.8%，而无 ARF 的 ICU 患者为 17.5%。仅对 46 例 ARF 患者中的 17.3%进行了急性血液透析。使用 Cox 比例风险回归，我们发现平均住院时间（p<0.001）、急性生理学和慢性健康评估 II（Apache II）评分（p<0.001）、机械通气（p<0.01）、透析（p<0.04）和多器官衰竭（p<0.05）影响生存时间。