Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Pulmonary and Pulmonary Critical Care Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Int J Clin Pract. 2021 Mar;75(3):e13745. doi: 10.1111/ijcp.13745. Epub 2020 Oct 27.
This study aimed to evaluate the risk factors and the association of acute kidney injury (AKI) with outcomes, and resource utilisation in patients hospitalised because of salicylate intoxication in the United States.
Hospitalised patients with a primary diagnosis of salicylate intoxication from 2003 to 2014 were identified in the National Inpatient Sample (NIS) database. End-stage kidney disease patients were excluded. The occurrence of AKI was identified using hospital diagnosis code. Clinical characteristics, in-hospital treatment, outcomes and resource utilisation were compared between patients with and without AKI.
A total of 13 787 eligible hospital admissions were included in the analysis. AKI occurred in 1279 (9.3%) admissions. Older age, male sex, more recent year of hospitalisation, anaemia, hypertension, congestive heart failure, chronic kidney disease, volume depletion, sepsis and ventricular arrhythmia/cardiac arrest were significantly associated with increased risk of AKI, whereas Hispanic race was associated with decreased risk. AKI was significantly associated with increased risk of organ failure, and in-hospital mortality. In addition, the need for ventilation support, blood component transfusion, renal replacement therapy, length of hospital stay and hospitalisation cost were higher in AKI patients.
Approximately one tenth of salicylate intoxication patients developed AKI during hospitalisation. AKI was associated with higher morbidity, mortality and resource utilisations.
本研究旨在评估美国因水杨酸盐中毒住院患者的危险因素及急性肾损伤(AKI)与结局和资源利用的相关性。
在美国国家住院患者样本(NIS)数据库中,确定了 2003 年至 2014 年间因水杨酸盐中毒而住院的患者。排除了终末期肾病患者。使用医院诊断代码来识别 AKI 的发生。比较 AKI 患者和无 AKI 患者的临床特征、住院治疗、结局和资源利用。
共纳入 13787 例符合条件的住院患者进行分析。1279 例(9.3%)住院患者发生 AKI。年龄较大、男性、较近的住院年份、贫血、高血压、充血性心力衰竭、慢性肾脏病、容量不足、败血症和室性心律失常/心脏骤停与 AKI 风险增加显著相关,而西班牙裔种族与 AKI 风险降低相关。AKI 与器官衰竭和住院期间死亡率增加显著相关。此外,AKI 患者需要通气支持、血液成分输血、肾脏替代治疗、住院时间和住院费用更高。
约十分之一的水杨酸盐中毒患者在住院期间发生 AKI。AKI 与更高的发病率、死亡率和资源利用有关。