急性肾损伤对入住儿科重症监护病房患者的影响。
Impact of the development of acute kidney injury on patients admitted to the pediatric intensive care unit.
机构信息
Hospital de Base de São José do Rio Preto, Hospital da Criança e Maternidade, UTI-Pediátrica, São José do Rio Preto, SP, Brazil.
Hospital de Base de São José do Rio Preto, Departamento de Nefrologia, São José do Rio Preto, SP, Brazil.
出版信息
J Pediatr (Rio J). 2020 Sep-Oct;96(5):576-581. doi: 10.1016/j.jped.2019.05.003. Epub 2019 Jul 22.
OBJECTIVE
To identify the risk factors for the development of acute kidney injury and for short and long-term mortality of patients with acute kidney injury after admission to the Pediatric Intensive Care Unit.
MATERIALS AND METHODS
Retrospective analysis of patients admitted to the Pediatric Intensive Care Unit from January 2004 to December 2008. Acute kidney injury was defined by the KDIGO criterion. Risk factors for acute kidney injury, in-hospital, and long-term mortality were obtained through multivariate logistic regression analysis. Long-term mortality (up to 2011) was obtained by searching the institution's database and by telephone contact with patients' family members.
RESULTS
A total of 434 patients were evaluated and the incidence of acute kidney injury was 64%. Most acute kidney injury episodes (78%) occurred within the first 24hours after admission to the Pediatric Intensive Care Unit. The risk factors for the development of acute kidney injury were: low volume of diuresis, younger age, mechanical ventilation, vasoactive drugs, diuretics, and amphotericin. Lower weight, positive fluid balance, acute kidney injury, dopamine use and mechanical ventilation were independent risk factors for in-hospital mortality. Long-term mortality was 17.8%. Systolic blood pressure, PRISM score, low volume of diuresis, and mechanical ventilation were independent risk factors associated with long-term mortality after admission to the Pediatric Intensive Care Unit.
CONCLUSION
Acute kidney injury was a frequent, early event, and was associated with in-hospital mortality and long-term mortality after admission to the Pediatric Intensive Care Unit.
目的
确定儿科重症监护病房（PICU）患者急性肾损伤（AKI）发展的风险因素，以及 AKI 患者住院和短期及长期死亡率的风险因素。
材料和方法
回顾性分析 2004 年 1 月至 2008 年 12 月期间收入 PICU 的患者。采用 KDIGO 标准定义 AKI。通过多变量逻辑回归分析获得 AKI、住院和长期死亡率的风险因素。通过搜索机构数据库和与患者家属电话联系获得长期死亡率（截至 2011 年）。
结果
共评估了 434 例患者，AKI 的发生率为 64%。大多数 AKI 发作（78%）发生在收入 PICU 后的前 24 小时内。AKI 发展的风险因素为：尿量少、年龄较小、机械通气、血管活性药物、利尿剂和两性霉素。体重较低、液体正平衡、AKI、多巴胺使用和机械通气是住院死亡率的独立危险因素。长期死亡率为 17.8%。入院后收缩压、PRISM 评分、尿量少和机械通气是与长期死亡率相关的独立危险因素。
结论
AKI 是一种常见的早期事件，与 PICU 患者的住院死亡率和长期死亡率相关。
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