200540School of Medicine, 8137New York Medical College, Valhalla, NY, USA.
Department of Neurosurgery, 8138Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Interv Neuroradiol. 2023 Feb;29(1):114-120. doi: 10.1177/15910199221076626. Epub 2022 Feb 3.
Acute kidney injury (AKI) is associated with poor outcome in aneurysmal subarachnoid hemorrhage patients (aSAH). Frailty has recently been demonstrated to correlate with elevated mortality and morbidity; its impact on predicting AKI and mortality in aSAH patients has not been investigated.
Evaluating risk factors and predictors for AKI in aSAH patients.
aSAH patients from a single-center's prospectively maintained database were retrospectively evaluated for development of AKI within 14 days of admission. Baseline demographic and clinical characteristics were collected. The effect of frailty and other risk factors were evaluated.
Of 213 aSAH patients, 53 (33.1%) were frail and 12 (5.6%) developed AKI. Admission serum creatinine (sCr) and peak sCr within 48 h were higher in frail patients. AKI patients showed a trend towards higher frailty. Mortality was significantly higher in AKI than non-AKI aSAH patients. Frailty was a poor predictor of AKI when controlling for Hunt and Hess (HH) grade or age. HH grade ≥ 4 strongly predicted AKI when controlling for frailty.
AKI in aSAH patients carries a poor prognosis. The HH grade appears to have superior utility as a predictor of AKI in aSAH patients than mFI.
急性肾损伤(AKI)与蛛网膜下腔出血患者(aSAH)的不良预后相关。最近已经证明脆弱与更高的死亡率和发病率相关;但其对预测 aSAH 患者 AKI 和死亡率的影响尚未被研究。
评估 aSAH 患者 AKI 的危险因素和预测因素。
对单中心前瞻性维护数据库中的 aSAH 患者进行回顾性评估,以确定入院后 14 天内是否发生 AKI。收集基线人口统计学和临床特征。评估脆弱和其他危险因素的影响。
在 213 名 aSAH 患者中,53 名(33.1%)为脆弱患者,12 名(5.6%)发生 AKI。脆弱患者的入院血清肌酐(sCr)和 48 小时内的峰值 sCr 较高。AKI 患者的脆弱程度呈上升趋势。与非 AKI aSAH 患者相比,AKI 患者的死亡率明显更高。在控制 Hunt 和 Hess(HH)分级或年龄后,脆弱是 AKI 的一个较差的预测指标。在控制脆弱的情况下,HH 分级≥4 强烈预测 AKI。
aSAH 患者的 AKI 预后不良。HH 分级似乎比 mFI 更能有效地预测 aSAH 患者的 AKI。