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心肺复苏成功后急性肾损伤与死亡率的关系:一项回顾性观察研究。

Association between acute kidney injury and mortality after successful cardiopulmonary resuscitation: a retrospective observational study.

机构信息

Reyhanlı Devlet Hastanesi, Anesthesia and Reanimation Department, Hatay, Turkey.

Mersin University, Anesthesia and Reanimation Department, Mersin, Turkey.

出版信息

Braz J Anesthesiol. 2022 Jan-Feb;72(1):122-127. doi: 10.1016/j.bjane.2021.02.026. Epub 2021 Feb 19.

DOI:10.1016/j.bjane.2021.02.026
PMID:34823839
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9373421/
Abstract

BACKGROUND AND OBJECTIVES

Acute Kidney Injury (AKI) affect mortality and morbidity in critically ill patients. There have been few studies examining the prevalence of AKI and mortality after successful cardiopulmonary resuscitation. In the present study, we investigated the association between AKI and mortality in post-cardiac arrest patients admitted to the Intensive Care Unit (ICU).

METHODS

Our retrospective analysis included 109 patients, admitted to the ICU following successful cardiopulmonary resuscitation between 2014 and 2016. We compared two scoring systems to estimate mortality.

RESULTS AND DISCUSSION

AKI were diagnosed in 46.7% (n = 51) of the patients based on the RIFLE criteria and 66.1% (n = 72) using the KDIGO. Mortality rate was significantly higher among patients with AKI diagnosed according to the RIFLE criteria (p = 0.012) and those with AKI diagnosed using KDIGO criteria (p = 0.003). Receiver Operating Characteristic (ROC) analysis showed that both scoring systems were able to successfully detect mortality (Area under the ROC curve = 0.693 for RIFLE and 0.731 for KDIGO).

CONCLUSION

AKI increases mortality and morbidity rates after cardiac arrest. Although more renal injury and mortality were detected with KDIGO, the sensitivity and specificity of both scoring systems were similar in predicting mortality in patients with Return of Spontaneous Circulation (ROSC).

摘要

背景与目的

急性肾损伤(AKI)会影响危重症患者的死亡率和发病率。很少有研究检查成功心肺复苏后 AKI 的患病率和死亡率。在本研究中,我们调查了 ICU 收治的心脏骤停后患者中 AKI 与死亡率之间的关系。

方法

我们的回顾性分析包括 2014 年至 2016 年期间成功心肺复苏后入住 ICU 的 109 名患者。我们比较了两种评分系统来估计死亡率。

结果与讨论

根据 RIFLE 标准,46.7%(n=51)的患者诊断为 AKI,根据 KDIGO 标准,66.1%(n=72)的患者诊断为 AKI。根据 RIFLE 标准诊断 AKI 的患者死亡率明显更高(p=0.012),根据 KDIGO 标准诊断 AKI 的患者死亡率也更高(p=0.003)。受试者工作特征(ROC)分析表明,两种评分系统均能成功检测到死亡率(RIFLE 的 ROC 曲线下面积为 0.693,KDIGO 的 ROC 曲线下面积为 0.731)。

结论

AKI 增加心脏骤停后患者的死亡率和发病率。尽管 KDIGO 检测到更多的肾损伤和死亡率,但两种评分系统在预测 ROSC 患者死亡率方面的敏感性和特异性相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/749d/9373421/a1ce4a24afc4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/749d/9373421/2eaa0e7a0fd1/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/749d/9373421/a1ce4a24afc4/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/749d/9373421/2eaa0e7a0fd1/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/749d/9373421/a1ce4a24afc4/gr2.jpg

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Crit Care. 2019 May 8;23(1):163. doi: 10.1186/s13054-019-2390-0.
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The incidence of acute kidney injury following cardiac arrest and cardiopulmonary resuscitation in a rat model.心脏骤停与心肺复苏后大鼠模型中急性肾损伤的发生率。
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