体重指数作为危重症患者急性肾损伤的预测指标：一项回顾性单中心研究
Body Mass Index as a Predictor of Acute Kidney Injury in Critically Ill Patients: A Retrospective Single-Center Study.
作者信息
Ju Sunmi, Lee Tae Won, Yoo Jung Wan, Lee Seung Jun, Cho Yu Ji, Jeong Yi Yeong, Lee Jong Deog, Kim Ju Young, Lee Gi Dong, Kim Ho Cheol
机构信息
Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
出版信息
Tuberc Respir Dis (Seoul). 2018 Oct;81(4):311-318. doi: 10.4046/trd.2017.0081. Epub 2018 Jun 19.
BACKGROUND
The aim of this study was to examine the influence of body mass index (BMI) on the development of acute kidney injury (AKI) in critically ill patients in intensive care unit (ICU).
METHODS
Data of patients admitted to medical ICU from December 2011 to May 2014 were retrospectively analyzed. Patients were classified into three groups according to their BMI: underweight (<18.5 kg/m²), normal (18.5-24.9 kg/m²), and overweight (≥25 kg/m²). The incidence of AKI was compared among these groups and factors associated with the development of AKI were analyzed. AKI was defined according to the Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) kidney disease criteria.
RESULTS
A total of 468 patients were analyzed. Their mean BMI was 21.5±3.9 kg/m², including 102 (21.8%) underweight, 286 (61.1%) normal-weight, and 80 (17.1%) overweight patients. Overall, AKI occurred in 82 (17.5%) patients. The overweight group had significantly (p<0.001) higher incidence of AKI (36.3%) than the underweight (9.8%) or normal group (15.0%). In addition, BMI was significantly higher in patients with AKI than that in those without AKI (23.4±4.2 vs. 21.1±3.7, p<0.001). Multivariate analysis showed that BMI was significantly associated with the development of AKI (odds ratio, 1.893; 95% confidence interval, 1.224-2.927).
CONCLUSION
BMI may be associated with the development of AKI in critically ill patients.
背景
本研究旨在探讨体重指数（BMI）对重症监护病房（ICU）危重病患者急性肾损伤（AKI）发生发展的影响。
方法
回顾性分析2011年12月至2014年5月入住内科ICU患者的数据。根据BMI将患者分为三组：体重过轻（<18.5kg/m²）、正常（18.5 - 24.9kg/m²）和超重（≥25kg/m²）。比较三组患者AKI的发生率，并分析与AKI发生相关的因素。AKI根据风险、损伤、衰竭、肾功能丧失和终末期（RIFLE）肾病标准进行定义。
结果
共分析了468例患者。他们的平均BMI为21.5±3.9kg/m²，其中体重过轻患者102例（21.8%），正常体重患者286例（61.1%），超重患者80例（17.1%）。总体而言，82例（17.5%）患者发生了AKI。超重组AKI的发生率（36.3%）显著高于体重过轻组（9.8%）和正常组（15.0%）（p<0.001）。此外，发生AKI的患者BMI显著高于未发生AKI的患者（23.4±4.2 vs. 21.1±3.7，p<0.001）。多因素分析显示，BMI与AKI的发生显著相关（比值比，1.893；95%置信区间，1.224 - 2.927）。
结论
BMI可能与危重病患者AKI的发生有关。
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