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髋关节骨折手术患者急性肾损伤的患病率及危险因素:一项荟萃分析。

The prevalence and risk factors of acute kidney injury in patients undergoing hip fracture surgery: a meta-analysis.

机构信息

Department of Orthopaedics, Wuwei People's Hospital, Wuwei, China.

出版信息

Bioengineered. 2021 Dec;12(1):1976-1985. doi: 10.1080/21655979.2021.1926200.

Abstract

Acute kidney injury (AKI) was a frequent complication following hip fracture surgery, but recent studies reported inconsistent findings. Our study was aimed at clarifying the prevalence and risk factors of AKI after hip fracture surgery. Pubmed, Embase, and Web of Science were systematically searched from the inception to March 2020 to identify observational studies investigating the prevalence and risk factors of AKI in patients undergoing hip fracture surgery. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a random-effects model. Publication bias was evaluated with a funnel plot and statistical test. All the statistical analyses were performed using Stata version 12.0. A total of 11 studies with 16,421 patients was included in the current meta-analysis. The pooled prevalence of AKI in patients undergoing hip fracture surgery was 17% (95%CI, 14%-21%) with substantial heterogeneity (I = 95%). Postoperative serum albumin (OR 1.80; 95%CI, 1.38-2.36) was a significant predictor for AKI. Age (OR 1.01; 95%CI, 0.95-1.07) and ACE inhibitors (OR 1.38; 95%CI, 0.92-2.07) were associated with increased the risk of AKI, but the results were not statistically significant. No significant publication bias was identified through statistical tests (Egger's test, = 0.258 and Begg's test, = 0.087). In conclusion, our findings indicated that he pooled AKI following hip fracture surgery was approximately 17%. Postoperative serum albumin was a potential significant risk factor for AKI.

摘要

急性肾损伤(AKI)是髋部骨折手术后的常见并发症,但最近的研究结果并不一致。本研究旨在阐明髋部骨折手术后 AKI 的患病率和危险因素。系统检索了PubMed、Embase 和 Web of Science 数据库,以确定研究髋部骨折手术后 AKI 患病率和危险因素的观察性研究。使用随机效应模型估计汇总患病率和比值比(OR)及其 95%置信区间(CI)。采用漏斗图和统计检验评估发表偏倚。使用 Stata 版本 12.0 进行所有统计分析。本 meta 分析共纳入了 11 项研究,共 16421 例患者。髋部骨折手术后 AKI 的总患病率为 17%(95%CI,14%-21%),存在较大异质性(I=95%)。术后血清白蛋白(OR 1.80;95%CI,1.38-2.36)是 AKI 的一个显著预测因子。年龄(OR 1.01;95%CI,0.95-1.07)和血管紧张素转换酶抑制剂(OR 1.38;95%CI,0.92-2.07)与 AKI 风险增加相关,但结果无统计学意义。通过统计检验未发现明显的发表偏倚(Egger 检验,t=0.258 和 Begg 检验,t=0.087)。总之,本研究结果表明髋部骨折手术后 AKI 的总体患病率约为 17%。术后血清白蛋白是 AKI 的一个潜在危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0301/8806851/220370da19e0/KBIE_A_1926200_UF0001_OC.jpg

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