Liaño F, García-Martín F, Gallego A, Orte L, Teruel J L, Marcén R, Matesanz R, Ortuño J
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Nephron. 1989;51(3):307-13. doi: 10.1159/000185314.
Multiple factors still influence the high rate of mortality in acute tubular necrosis. Trying to analyze the influence of each risk factor present in an individual patient and the possible interdependence between these factors, as well as to obtain an early prognosis, we have applied a forward analysis to demographic data, acute renal failure origin, need of dialysis, diuresis and clinical conditions in 228 patients, using a multiple linear regression model contained in a computer package. Based on this approach we have found that three variables: deep neurological coma, persistent blood hypotension and assisted respiration have significant influence on mortality. Also, a regression equation was obtained which could be applied as a discriminant score to patient prognosis. This score, calculated with the three aforementioned variables and oliguria when the nephrologist sees the patient for the first time, allows an easy and early prognosis in each patient with acute tubular necrosis.
多种因素仍然影响着急性肾小管坏死的高死亡率。为了分析个体患者中存在的每个风险因素的影响以及这些因素之间可能的相互依存关系，并获得早期预后，我们使用计算机软件包中包含的多元线性回归模型，对228例患者的人口统计学数据、急性肾衰竭的病因、透析需求、尿量及临床状况进行了前瞻性分析。基于这种方法，我们发现三个变量：深度神经昏迷、持续性血压过低和辅助呼吸对死亡率有显著影响。此外，还获得了一个回归方程，可将其用作患者预后的判别评分。该评分由上述三个变量以及肾病科医生首次接诊患者时的少尿情况计算得出，能够对每位急性肾小管坏死患者进行简单且早期的预后评估。
