Department of Nursing, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia.
Department of Pediatric and Child Health Nursing, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
PLoS One. 2024 Jun 26;19(6):e0304006. doi: 10.1371/journal.pone.0304006. eCollection 2024.
Acute kidney injury is a prevalent complication in the Intensive Care Unit (ICU) and a significant global public health concern. It affects approximately 13 million individuals and contributes to nearly two million deaths worldwide. Acute kidney injury among Intensive Care Unit patients is closely associated with higher rates of morbidity and mortality. This study aims to assess the incidence of acute kidney injury and identify predictors among adult patients admitted to the medical Intensive Care Unit.
A retrospective follow-up study was conducted by reviewing charts of 317 systematically selected patients admitted to the Intensive Care Unit from September 1, 2018, to August 30, 2022, in Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital. The extraction tool was used for the data collection, Epi-data version 4.6.0 for data entry, and STATA version 14 for data cleaning and analysis. The Kaplan-Meier, log-rank test, and life table were used to describe the data. The Cox proportional hazard regression model was used for analysis.
Among the total study participants, 128 (40.4%) developed Acute Kidney Injury (AKI). The incidence rate of Acute Kidney Injury was 30.1 (95% CI: 25.33, 35.8) per 1000 person-days of observation, with a median survival time of 23 days. It was found that patients with invasive mechanical ventilation (AHR = 2.64; 95% CI: 1.46-4.78), negative fluid balance (AHR = 2.00; 95% CI: 1.30-3.03), hypertension (AHR = 1.6; 95% CI: 1.05-2.38), and a vasopressor (AHR = 1.72; 95% CI: 1.10-2.63) were independent predictors of acute kidney injury.
The incidence of Acute Kidney Injury was a major concern in the ICU of the study area. In the intensive care unit (ICU), it was found that patients with vasopressors, invasive mechanical ventilation, negative fluid balance, and chronic hypertension were independent predictors of developing AKI. It would be better if clinicians in the ICU provided targeted interventions through close monitoring and evaluation of those patients with invasive ventilation, chronic hypertension, negative fluid balance, and vasopressors.
急性肾损伤是重症监护病房(ICU)中普遍存在的并发症,也是一个重大的全球公共卫生问题。它影响了约 1300 万人,并导致全球近 200 万人死亡。重症监护病房患者的急性肾损伤与更高的发病率和死亡率密切相关。本研究旨在评估成人患者入住内科重症监护病房后急性肾损伤的发生率,并确定其预测因素。
通过回顾 2018 年 9 月 1 日至 2022 年 8 月 30 日期间在 Wachemo 大学 Nigist Ellen Mohammed 纪念综合专科医院内科重症监护病房收治的 317 例系统选择的患者的图表,进行了一项回顾性随访研究。使用提取工具进行数据收集,使用 Epi-data 版本 4.6.0 进行数据录入,使用 STATA 版本 14 进行数据清理和分析。使用 Kaplan-Meier、对数秩检验和寿命表描述数据。使用 Cox 比例风险回归模型进行分析。
在总共的研究参与者中,有 128 人(40.4%)出现急性肾损伤(AKI)。急性肾损伤的发生率为 30.1(95%CI:25.33,35.8)/1000 人-日的观察,中位生存时间为 23 天。结果发现,接受有创机械通气的患者(AHR=2.64;95%CI:1.46-4.78)、液体负平衡的患者(AHR=2.00;95%CI:1.30-3.03)、高血压患者(AHR=1.6;95%CI:1.05-2.38)和血管加压素治疗的患者(AHR=1.72;95%CI:1.10-2.63)是急性肾损伤的独立预测因素。
急性肾损伤的发生率是研究区域 ICU 的一个主要问题。在重症监护病房(ICU)中,发现接受血管加压素、有创机械通气、液体负平衡和慢性高血压的患者是发生 AKI 的独立预测因素。如果 ICU 的临床医生通过对接受有创通气、慢性高血压、液体负平衡和血管加压素治疗的患者进行密切监测和评估,提供有针对性的干预措施,情况可能会更好。