危重症癌症患者的急性肾损伤与死亡率相关：一项回顾性分析。
Acute kidney injury in critically ill cancer patients is associated with mortality: A retrospective analysis.
机构信息
Department of Critical Care, King's College London, Guy's & St Thomas' Hospital Foundation Trust, London, United Kingdom.
Sechenov Biomedical Science and Technology Park, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
出版信息
PLoS One. 2020 May 21;15(5):e0232370. doi: 10.1371/journal.pone.0232370. eCollection 2020.
BACKGROUND
In critically ill patients, acute kidney injury (AKI) is common and associated with short- and long-term complications. Our objectives were to describe the epidemiology and impact of AKI in cancer patients admitted to the Intensive Care Unit (ICU).
METHODS
We identified all patients with a haematological malignancy (HM) or solid tumour (ST) who had an emergency admission to the ICU in a tertiary care centre between January 2004 and July 2012. AKI was defined according to the KDIGO criteria.
RESULTS
429 patients were included of whom 259 (60%) had AKI. Among HM patients, 73 (78%) had AKI (70% AKI on admission to ICU; 7% during ICU stay); among ST patients, 186 (56%) had AKI (45% on admission to ICU, 11% during ICU stay). ICU and 28-day mortality rates were 33% and 48%, respectively in HM patients, and 22% and 31%, respectively in ST patients. Multivariable analysis showed that AKI was an independent risk factor for both ICU and 28-day mortality. New AKI after 24 hours in ICU was associated with higher mortality than AKI on admission.
CONCLUSIONS
AKI is common in critically ill cancer patients and independently associated with ICU and 28-day mortality.
背景
在危重症患者中，急性肾损伤（AKI）很常见，并与短期和长期并发症相关。我们的目的是描述 ICU 收治的癌症患者 AKI 的流行病学和影响。
方法
我们确定了 2004 年 1 月至 2012 年 7 月期间在一家三级护理中心因急症入住 ICU 的所有血液恶性肿瘤（HM）或实体瘤（ST）患者。AKI 根据 KDIGO 标准定义。
结果
共纳入 429 例患者，其中 259 例（60%）患有 AKI。HM 患者中，73 例（78%）有 AKI（70%在 ICU 入住时发生 AKI；7%在 ICU 期间发生）；ST 患者中，186 例（56%）有 AKI（45%在 ICU 入住时发生 AKI，11%在 ICU 期间发生）。HM 患者的 ICU 和 28 天死亡率分别为 33%和 48%，ST 患者分别为 22%和 31%。多变量分析显示 AKI 是 ICU 和 28 天死亡率的独立危险因素。ICU 入住 24 小时后新发 AKI 与死亡率升高相关，高于 AKI 入院时。
结论
AKI 在危重症癌症患者中很常见，与 ICU 和 28 天死亡率独立相关。
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