红细胞分布宽度与白蛋白比值与脓毒症患者急性肾损伤的关系：基于 MIMIC 的人群研究。
Association between red cell distribution width to albumin ratio and acute kidney injury in patients with sepsis: a MIMIC population-based study.
机构信息
Department of Emergency Medicine, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, No. 188, Lingshan North Road, Qixia District, Nanjing, 210046, People's Republic of China.
Department of Emergency Medicine, Taikang Xianlin Drum Tower Hospital Clinical College of Wuhan University, Nanjing, 210046, People's Republic of China.
出版信息
Int Urol Nephrol. 2023 Nov;55(11):2943-2950. doi: 10.1007/s11255-023-03572-7. Epub 2023 Apr 4.
PURPOSE
To investigate the association between red cell distribution width (RDW) to albumin (ALB) ratio and acute kidney injury (AKI) in sepsis.
METHODS
This was a retrospective cohort study. Data were collected from the Medical Information Mart for Intensive Care Database IV (MIMIC-IV) from 2008 to 2019. The incidence of AKI was the primary outcome, which was defined based on the improving Global Outcomes (KDIGO). The association of RDW/ALB ratio with AKI in sepsis was assessed by multivariate logistic regression analysis using relative risk (RR) and a 95% confidence interval (CI). Subgroup group analyses were applied according to age, use of ventilation, and use of vasopressor, SAPS II, and SOFA.
RESULTS
Of 1810 sepsis patients involved in this study, 563 (31.10%) sepsis patients developed AKI after ICU admission. The results suggested an increase in RDW/ALB was associated with a rise in the risk of AKI in sepsis (RR 1.09, 95% CI 1.02 to 1.16, P = 0.013).Based on the subgroup analysis, RDW/ALB ratio was significantly associated with the risk of AKI in sepsis patients using the treatment of ventilation (RR: 1.07, 95% CI 1.01 to 1.14, P = 0.041)) and in patients with SAPS II < 43 (RR: 1.16, 95% CI 1.04 to 1.29, P = 0.007).
CONCLUSION
RDW/ALB ratio was independently associated with the risk of AKI in sepsis patients.
目的
探讨红细胞分布宽度（RDW）与白蛋白（ALB）比值与脓毒症急性肾损伤（AKI）的关系。
方法
这是一项回顾性队列研究。数据来自 2008 年至 2019 年的医疗信息集市重症监护数据库 IV（MIMIC-IV）。AKI 的发生率为主要结局，根据改善全球结局（KDIGO）定义。采用多变量逻辑回归分析，使用相对风险（RR）和 95%置信区间（CI）评估 RDW/ALB 比值与脓毒症 AKI 的关系。根据年龄、使用通气、使用血管加压药、SAPS II 和 SOFA 进行亚组分析。
结果
在本研究纳入的 1810 例脓毒症患者中，563 例（31.10%）脓毒症患者在 ICU 入院后发生 AKI。结果表明，RDW/ALB 升高与脓毒症 AKI 风险增加相关（RR 1.09，95%CI 1.02 至 1.16，P=0.013）。基于亚组分析，RDW/ALB 比值与使用通气治疗的脓毒症患者（RR：1.07，95%CI 1.01 至 1.14，P=0.041）和 SAPS II <43 的患者（RR：1.16，95%CI 1.04 至 1.29，P=0.007）的 AKI 风险显著相关。
结论
RDW/ALB 比值与脓毒症患者 AKI 的风险独立相关。
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