发展中国家一所大学医院内科重症监护病房中老年与非老年患者的急性肾损伤结局

Acute Kidney Injury Outcomes of Elderly and Nonelderly Patients in the Medical Intensive Care Unit of a University Hospital in a Developing Country.

作者信息

Pongsittisak Wanjak, Phonsawang Kashane, Jaturapisanukul Solos, Prommool Surazee, Kurathong Sathit

机构信息

Renal Division, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.

Renal Unit, Department of Internal Medicine, Sirindhorn Hospital, Bangkok, Thailand.

出版信息

Crit Care Res Pract. 2020 Jan 30;2020:2391683. doi: 10.1155/2020/2391683. eCollection 2020.

DOI:10.1155/2020/2391683

PMID:32399291

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7204352/

Abstract

BACKGROUND

Aging is associated with a high risk of acute kidney injury (AKI), and the elderly with AKI show a higher mortality rate than those without AKI. In this study, we compared AKI outcomes between elderly and nonelderly patients in a university hospital in a developing country.

MATERIALS AND METHODS

This retrospective cohort study included patients with AKI who were admitted to the medical intensive care unit (ICU) between January 1, 2012, and December 31, 2017. The patients were divided into the elderly (eAKI; age ≥65 years; = 158) and nonelderly (nAKI; = 142) groups. Baseline characteristics, comorbidities, principle diagnosis, renal replacement therapy (RRT) requirement, hospital course, and in-hospital mortality were recorded. The primary outcome was in-hospital mortality.

RESULTS

The eAKI group included more females, patients with higher Acute Physiology and Chronic Health Evaluation II scores, and patients with more comorbidities than the nAKI group. The etiology and staging of AKI were similar between the two groups. There were no significant differences in in-hospital mortality (=0.338) and RRT requirement (=0.802) between the two groups. After adjusting for covariates, the 28-day mortality rate was similar between the two groups (=0.654), but the 28-day RRT requirement was higher in the eAKI group than in the nAKI group (=0.042).

CONCLUSION

Elderly and nonelderly ICU patients showed similar survival outcomes of AKI, although the elderly were at a higher risk of requiring RRT.

摘要

背景

衰老与急性肾损伤（AKI）的高风险相关，患有AKI的老年人死亡率高于未患AKI的老年人。在本研究中，我们比较了发展中国家一家大学医院中老年患者和非老年患者的AKI结局。

材料与方法

这项回顾性队列研究纳入了2012年1月1日至2017年12月31日期间入住医学重症监护病房（ICU）的AKI患者。患者被分为老年组（eAKI；年龄≥65岁；n = 158）和非老年组（nAKI；n = 142）。记录基线特征、合并症、主要诊断、肾脏替代治疗（RRT）需求、住院病程和院内死亡率。主要结局是院内死亡率。

结果

与nAKI组相比，eAKI组女性更多，急性生理与慢性健康状况评估II评分更高，合并症更多。两组间AKI的病因和分期相似。两组间院内死亡率（P = 0.338）和RRT需求（P = 0.802）无显著差异。调整协变量后，两组间28天死亡率相似（P = 0.654），但eAKI组28天RRT需求高于nAKI组（P = 0.042）。