血清镁水平与创伤性脑损伤患者急性肾损伤风险的关联：来自 MIMIC-IV 数据库的回顾性队列研究。
Association between Serum Magnesium Levels and Risk of Acute Kidney Injury in Patients with Traumatic Brain Injury: A Retrospective Cohort Study from the MIMIC-IV Database.
机构信息
Department of Neurosurgery, The Second People's Hospital of Liaocheng, Linqing, China.
Department of Pediatric Internal Medicine, The Second People's Hospital of Liaocheng, Linqing, China.
出版信息
Blood Purif. 2024;53(8):603-612. doi: 10.1159/000539507. Epub 2024 Jun 5.
INTRODUCTION
The occurrence of acute kidney injury (AKI) is associated with a higher risk of mortality in patients with traumatic brain injury (TBI). This study aimed to explore the relationship between serum magnesium levels and the risk of AKI in patients with TBI.
METHODS
Patients with TBI were identified from the Medical Information Mart Intensive Care IV (MIMIC-IV) 2008-2019. The relationship between serum magnesium levels at admission and magnesium coefficient of variation (CV) during hospitalization and the risk of AKI was analyzed using multivariable logistic regression analysis and expressed as odds ratio (OR) and 95% confidence interval (CI). Subgroup analyses were performed according to Glasgow Coma Scale (GCS) score (<14, ≥14), sepsis (no, yes), and estimated glomerular filtration rate (eGFR; <60, ≥60).
RESULTS
Of the 991 patients included, 140 (14.13%) developed AKI during hospitalization. Patients with magnesium levels ≤1.7 mg/dL (tertile 1) (OR = 1.68, 95% CI: 1.01-2.81) were associated with a higher risk of AKI compared to those with magnesium levels of 1.7-2.0 mg/dL (tertile 2), but no association was found in those with magnesium levels >2.0 mg/dL (tertile 3) (p = 0.479). For magnesium CV, patients with magnesium CV >10% (tertile 3) (OR = 2.26, 95% CI: 1.16-4.41) were linked to an increased risk of AKI compared to those with magnesium CV ≤4% (tertile 1), but there may be a slight association between magnesium CV of 4%-10% (tertile 2) and AKI risk (OR = 1.86, 95% CI: 0.99-3.48; p = 0.053). Subgroup analyses showed that lower magnesium levels (≤1.7 mg/dL) or greater magnesium CV (>10%) were associated with a higher risk of AKI only in patients with a GCS score ≥14, non-sepsis, or eGFR ≥60 mL/min/1.73 m2 (p < 0.05).
CONCLUSION
Lower serum magnesium levels at admission or greater magnesium CV during hospitalization were associated with a higher risk of AKI in patients with TBI.
简介
急性肾损伤（AKI）的发生与创伤性脑损伤（TBI）患者的死亡率升高相关。本研究旨在探讨血清镁水平与 TBI 患者 AKI 风险之间的关系。
方法
从 2008 年至 2019 年的医疗信息集市重症监护 IV（MIMIC-IV）中确定 TBI 患者。使用多变量逻辑回归分析来分析入院时血清镁水平和住院期间镁变异系数（CV）与 AKI 风险之间的关系，并表示为比值比（OR）和 95%置信区间（CI）。根据格拉斯哥昏迷量表（GCS）评分（<14，≥14）、脓毒症（无，有）和估计肾小球滤过率（eGFR；<60，≥60）进行亚组分析。
结果
在纳入的 991 名患者中，有 140 名（14.13%）在住院期间发生 AKI。与镁水平为 1.7-2.0mg/dL（第三层）的患者相比，镁水平≤1.7mg/dL（第一层）（OR=1.68，95%CI：1.01-2.81）的患者发生 AKI 的风险更高，但镁水平>2.0mg/dL（第三层）的患者无此关联（p=0.479）。对于镁 CV，镁 CV>10%（第三层）（OR=2.26，95%CI：1.16-4.41）的患者与镁 CV≤4%（第一层）的患者相比，发生 AKI 的风险增加，但镁 CV 为 4%-10%（第二层）的患者与 AKI 风险之间可能存在轻微关联（OR=1.86，95%CI：0.99-3.48；p=0.053）。亚组分析表明，只有在 GCS 评分≥14、非脓毒症或 eGFR≥60mL/min/1.73m2 的患者中，较低的镁水平（≤1.7mg/dL）或较大的镁 CV（>10%）与 AKI 风险较高相关（p<0.05）。
结论
入院时血清镁水平较低或住院期间镁 CV 较大与 TBI 患者 AKI 风险较高相关。
Zotero 插件