Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea.
J Crit Care. 2024 Dec;84:154898. doi: 10.1016/j.jcrc.2024.154898. Epub 2024 Aug 20.
To investigate the relationship between contrast medium administration and long-term mortality and renal function in patients with septic acute kidney injury (AKI).
We performed a retrospective, propensity-matched cohort study involving 1521 adult patients admitted with septic shock. Patients with septic AKI who underwent contrast or non-contrast CT scans were enrolled. The primary outcomes were the rates of 90-day mortality and dialysis within 90 days. The secondary outcomes included worsening of AKI, in-hospital mortality, and maintenance of dialysis after 90 days.
During the study period, 609 patients with septic AKI were identified; 220 (36.1%) underwent contrast CT and 389 (63.9%) underwent non-contrast CT. After propensity score matching, 133 pairs were obtained. There were no significant differences between the contrast and non-contrast CT groups in 90-day mortality (54.9% vs. 58.6%, P = 0.579), dialysis within 90 days (6.8% vs. 8.3%, P = 0.655), worsening AKI (2.3% vs. 3.0%, P = 0.706), in-hospital mortality (10.6% vs. 14.4%, P = 0.369), or maintenance of dialysis after 90 days (0.0% vs. 0.8%, P > 0.99).
The administration of intravenous contrast medium was not associated with long-term mortality, deterioration of renal function, or dialysis in patients with septic AKI.
研究对比剂给药与脓毒性急性肾损伤（AKI）患者的长期死亡率和肾功能之间的关系。
我们进行了一项回顾性、倾向评分匹配队列研究，纳入了 1521 名因感染性休克入院的成年患者。纳入接受对比或非对比 CT 扫描的脓毒性 AKI 患者。主要结局为 90 天死亡率和 90 天内透析率。次要结局包括 AKI 恶化、住院期间死亡率和 90 天后维持透析。
在研究期间，共确定了 609 名脓毒性 AKI 患者，其中 220 名（36.1%）接受了对比 CT 检查，389 名（63.9%）接受了非对比 CT 检查。经倾向评分匹配后，共获得 133 对。在 90 天死亡率（54.9% vs. 58.6%，P=0.579）、90 天内透析率（6.8% vs. 8.3%，P=0.655）、AKI 恶化率（2.3% vs. 3.0%，P=0.706）、住院期间死亡率（10.6% vs. 14.4%，P=0.369）或 90 天后维持透析率（0.0% vs. 0.8%，P＞0.99）方面，对比剂组与非对比剂组之间无显著差异。
在脓毒性 AKI 患者中，静脉内对比剂的使用与长期死亡率、肾功能恶化或透析无关。
