Phillips Dafydd, Young Oliver, Holmes Jennifer, Allen Lowri A, Roberts Gethin, Geen John, Williams John D, Phillips Aled O
Institute of Nephrology, Cardiff University School of Medicine, Cardiff, UK.
Welsh Renal Clinical Network, Cwm Taf University Health Board, Abercynon, UK.
Int J Clin Pract. 2017 Sep;71(9). doi: 10.1111/ijcp.13000. Epub 2017 Sep 4.
To identify any seasonal variation in the occurrence of, and outcome following Acute Kidney Injury.
The study utilised the biochemistry based AKI electronic (e)-alert system established across the Welsh National Health Service to collect data on all AKI episodes to identify changes in incidence and outcome over one calendar year (1st October 2015 and the 30th September 2016).
There were total of 48 457 incident AKI alerts. The highest proportion of AKI episodes was seen in the quarter of January to March (26.2%), and the lowest in the quarter of October to December (23.3%, P < .001). The same trend was seen for both community-acquired and hospital-acquired AKI sub-sets. Overall 90 day mortality for all AKI was 27.3%. In contrast with the seasonal trend in AKI occurrence, 90 day mortality after the incident AKI alert was significantly higher in the quarters of January to March and October to December compared with the quarters of April to June and July to September (P < .001) consistent with excess winter mortality reported for likely underlying diseases which precipitate AKI.
In summary we report for the first time in a large national cohort, a seasonal variation in the incidence and outcomes of AKI. The results demonstrate distinct trends in the incidence and outcome of AKI.
确定急性肾损伤的发生及预后是否存在季节性变化。
本研究利用威尔士国民医疗服务体系建立的基于生物化学的急性肾损伤电子警报系统,收集所有急性肾损伤发作的数据,以确定一历年(2015年10月1日至2016年9月30日)期间发病率和预后的变化。
共发出48457次急性肾损伤事件警报。急性肾损伤发作比例最高的是1月至3月季度(26.2%),最低的是10月至12月季度(23.3%,P < 0.001)。社区获得性和医院获得性急性肾损伤子集均呈现相同趋势。所有急性肾损伤的总体90天死亡率为27.3%。与急性肾损伤发生的季节性趋势相反,急性肾损伤事件警报后的90天死亡率在1月至3月和10月至12月季度显著高于4月至6月和7月至9月季度(P < 0.001),这与可能引发急性肾损伤的潜在疾病报告的冬季死亡率过高一致。
总之,我们首次在一个大型全国队列中报告了急性肾损伤发病率和预后的季节性变化。结果显示了急性肾损伤发病率和预后的明显趋势。