Buargub Mahdia, Elmokhtar Zohra Omar
Nephrology Unit, Tripoli Central Hospital, Tripoli, Libya.
Tajoura Cardiology Center, Tripoli, Libya.
Saudi J Kidney Dis Transpl. 2016 Jul-Aug;27(4):752-7. doi: 10.4103/1319-2442.185238.
Acute kidney injury (AKI) is associated with adverse short-and long-term outcomes. The aim of this study was to evaluate the incidence of AKI and the short-term mortality in patients admitted with acute coronary syndrome (ACS) to a single coronary care unit (CCU) in Tripoli, Libya. We retrospectively studied the medical records of ACS patients admitted to the CCU of a referral cardiology center, during the period from January 1, 2014, to December 31, 2014. AKI was defined according to the AKI network criteria. The incidence of AKI and short-term CCU mortality was compared between different types of ACS. Data of patients with and without AKI were compared using Student's t-test and Chi-squared statistic considering P <0.05 statistically significant. Eighty-four patients with ACS were included in the study; their mean age was 57.6 ± 14.4 years [standard deviation (SD)], 75% were males and their mean stay in the CCU was 4.3 ± 3 days (SD). Of them, 71.4% had ST-elevated myocardial infarction (STEMI), 22.6% had non-STEMI, and 6% had unstable angina. About 41.7% had AKI (19% had AKI Stage 1, 17.9% had AKI Stage 2, and 4.8% had AKI Stage 3). The total CCU mortality was 15.5%; mortality among AKI patients in the CCU was 25.7% compared with 6.12% in the non-AKI patients (P = 0.014). The mortality worsened with increasing severity of AKI. Patients with AKI were older (61.6 ± 15 years) than the non-AKI group (54.7 ± 13 years, P = 0.031), their mean blood pressure at admission was lower, their CCU stay was longer, and they more frequently had coexisting acute decompensated heart failure. In this study of ACS patients, the incidence of AKI was high, the CCU mortality among the AKI patients was 25.7% compared with 6.12% in the non-AKI patients, and the mortality worsened with increasing severity of AKI.
急性肾损伤（AKI）与不良的短期和长期预后相关。本研究的目的是评估利比亚的黎波里一家单一冠心病监护病房（CCU）收治的急性冠脉综合征（ACS）患者中AKI的发生率及短期死亡率。我们回顾性研究了2014年1月1日至2014年12月31日期间转诊至心脏病学中心CCU的ACS患者的病历。AKI根据急性肾损伤网络标准进行定义。比较不同类型ACS患者中AKI的发生率和CCU短期死亡率。使用学生t检验和卡方统计量比较有AKI和无AKI患者的数据，P<0.05具有统计学意义。84例ACS患者纳入本研究；他们的平均年龄为57.6±14.4岁[标准差（SD）]，75%为男性，他们在CCU的平均住院时间为4.3±3天（SD）。其中，71.4%为ST段抬高型心肌梗死（STEMI），22.6%为非STEMI，6%为不稳定型心绞痛。约41.7%有AKI（19%为AKI 1期，17.9%为AKI 2期，4.8%为AKI 3期）。CCU总死亡率为15.5%；CCU中AKI患者的死亡率为25.7%，而非AKI患者为6.12%（P=0.014）。死亡率随AKI严重程度的增加而升高。有AKI的患者年龄更大（61.6±15岁），高于无AKI组（54.7±13岁，P=0.031），他们入院时的平均血压更低，在CCU的住院时间更长，并且更频繁地合并急性失代偿性心力衰竭。在这项对ACS患者的研究中，AKI的发生率较高，AKI患者的CCU死亡率为25.7%，而非AKI患者为6.12%，且死亡率随AKI严重程度的增加而升高。
