左心室舒张功能障碍与严重脓毒症和脓毒性休克中脓毒症急性肾损伤的关系：一项多中心回顾性研究。

Association between left ventricular diastolic dysfunction and septic acute kidney injury in severe sepsis and septic shock: A multicenter retrospective study.

机构信息

Department of Emergency, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.

Department of Intensive Care Unit, Fujian Provincial Hospital, Fuzhou, Fujian Province, China.

出版信息

Perfusion. 2022 Mar;37(2):175-187. doi: 10.1177/0267659121988969. Epub 2021 Jan 21.

DOI:10.1177/0267659121988969

PMID:33475032

Abstract

INTRODUCTION

Left ventricular diastolic dysfunction (LVDD) adversely impacts renal function, and E/e' is a significant predictor of adverse kidney events under different clinical conditions. However, no studies have evaluated the association between LVDD and septic acute kidney injury (AKI) among patients with severe sepsis and septic shock.

METHODS

This multicenter retrospective study evaluated adult patients with severe sepsis or septic shock between January 1, 2013, and December 31, 2019, who underwent echocardiography within 24 hours after admission to an intensive care unit.

RESULTS

A total of 495 adult patients were enrolled in the study. LVDD grades II and III were associated with severe (stage 3) AKI ( < 0.001, for trend < 0.001). E/e' and e' were risk factors for septic AKI (OR, 1.155; 95% CI, 1.088-1.226, < 0.001; and OR, 7.218; 95% CI, 2.942-17.712, < 0.001, respectively) in the multivariate logistic regression analysis. The area under the receiver operating characteristic curve of E/e' and e' was 0.728 (95% CI, 0.680-0.777, < 0.001) and 0.715 (95% CI, 0.665-0.764, < 0.001), respectively.

CONCLUSIONS

LVDD was associated with septic AKI, and E/e' and e' are useful predictors of septic AKI among patients with severe sepsis or septic shock.

TRIAL REGISTRATION

The study was registered at the Chinese Clinical Trial Registry (Protocol No. ChiCTR2000033083).

摘要

简介

左心室舒张功能障碍（LVDD）会对肾功能产生不利影响，E/e' 是不同临床情况下不良肾脏事件的重要预测指标。然而，目前尚无研究评估 LVDD 与严重脓毒症和脓毒性休克患者脓毒性急性肾损伤（AKI）之间的关系。

方法

这项多中心回顾性研究评估了 2013 年 1 月 1 日至 2019 年 12 月 31 日期间入住重症监护病房 24 小时内接受超声心动图检查的成人严重脓毒症或脓毒性休克患者。

结果

共有 495 名成年患者纳入研究。LVDD 分级 II 和 III 与严重（第 3 期）AKI 相关（ < 0.001，趋势检验 < 0.001）。E/e' 和 e' 是脓毒性 AKI 的危险因素（比值比，1.155；95%置信区间，1.088-1.226， < 0.001；和比值比，7.218；95%置信区间，2.942-17.712， < 0.001，分别）。E/e' 和 e' 的受试者工作特征曲线下面积分别为 0.728（95%置信区间，0.680-0.777， < 0.001）和 0.715（95%置信区间，0.665-0.764， < 0.001）。