Division of Nephrology, Huashan Hospital, Fudan University, 12 Wulumuqi Road (Middle), Shanghai 200040, China.
Arch Gerontol Geriatr. 2012 Mar-Apr;54(2):e47-51. doi: 10.1016/j.archger.2011.05.011.
Elderly patients with AKI are associated with considerable mortality. The clinical features and risk factors predicting poor outcomes of these patients are not known. The aim of this study is to investigate the clinical features and risk factors affecting mortality in elderly patients with AKI.
A prospective study on the elderly patients with AKI (age ≥65 years old) was conducted. A consecutive sample of 99 elderly patients with AKI was evaluated. These patients were divided into survivor group and non-survivor group according their outcomes. Factors including clinical characteristics and laboratory features were compared between these two groups. Analysis of correlations between death and categorized risk factors was done by means of Pearson's chi-squared test (or Fisher's exact test). Multivariate logistic regression was performed to analyze the possible risk factors for death.
The main causes of the elderly patients with AKI were ischemia (53.34%), surgery (33.33%), sepsis/infection (10.10%), nephrotoxic drug (3.03%). The mortality rate of the elderly patients with AKI was 42%. Significant differences were found between the survival group and non-survival group of the elderly patients in concomitant disease, complicated with multiple organ dysfunction syndrome (MODS), albumin, etc. Concomitant disease and MODS were found to be the independent risk factors for death of the elderly patients with AKI after adjusting for age, sex, pre-albumin, sepsis/infection, and serum creatinine (SCr).
This study found that concomitant disease and MODS were the independent risk factors for the death of elderly patients with AKI.
急性肾损伤（AKI）老年患者的死亡率相当高。目前尚不清楚这些患者的临床特征和预测不良预后的危险因素。本研究旨在探讨影响 AKI 老年患者死亡率的临床特征和危险因素。
对 AKI 老年患者（年龄≥65 岁）进行前瞻性研究。评估了 99 例 AKI 老年患者的连续样本。根据结局将这些患者分为存活组和非存活组。比较两组患者的临床特征和实验室特征。通过 Pearson 卡方检验（或 Fisher 确切概率法）分析死亡与分类危险因素之间的相关性。采用多因素 logistic 回归分析死亡的可能危险因素。
AKI 老年患者的主要病因是缺血（53.34%）、手术（33.33%）、脓毒症/感染（10.10%）、肾毒性药物（3.03%）。AKI 老年患者的死亡率为 42%。存活组和非存活组 AKI 老年患者在并存疾病、合并多器官功能障碍综合征（MODS）、白蛋白等方面存在显著差异。在调整年龄、性别、前白蛋白、脓毒症/感染和血清肌酐（SCr）后，并存疾病和 MODS 是 AKI 老年患者死亡的独立危险因素。
本研究发现并存疾病和 MODS 是 AKI 老年患者死亡的独立危险因素。
