危重症患者急性肾损伤的预后评分
Prognostic Scores for Acute Kidney Injury in Critically Ill Patients.
作者信息
Sousa Wisble Pereira, Magro Marcia Cristina da Silva, Paiva Alberto Augusto Martins, Vasconcelos Ruth Silva Rodrigues, Dos Reis Abraão Alves, Lima Wellington Luiz de, Duarte Tayse Tâmara da Paixão
机构信息
Faculty of Health Sciences and Technology, University of Brasília/UnB, Brasília 72220-275, Brazil.
Postgraduate Program in Nursing, University of Brasília, Brasília 70910-900, Brazil.
出版信息
Nurs Rep. 2024 Nov 20;14(4):3619-3630. doi: 10.3390/nursrep14040264.
BACKGROUND
Numerous prognostic scores have been developed and used in intensive care; however, the applicability and effectiveness of these scores in critically ill patients with acute kidney injury may vary due to the characteristics of this population.
OBJECTIVE
To assess the predictive capacity of the Simplified Acute Physiology Score III (SAPS III), Sequential Sepsis-related Organ Failure Assessment (SOFA) and Nursing Activities Score (NAS) prognostic scoring systems for acute kidney injury in critically ill patients.
METHODS
Cohort, prospective and quantitative study with follow-up of 141 critical patients in intensive care. A questionnaire was used to collect information about the capacity of prognostic scoring systems to predict AKI. Mann-Whitney, Kruskal-Wallis and Bonferroni-corrected Mann-Whitney tests were used and the statistical significance was considered to be at two-sided < 0.05.
RESULTS
It was revealed that 41.85% of patients developed acute kidney injury during their stay in the Intensive Care Unit and indicated greater severity assessed by the medians of prognostic scoring systems-SAPS III [55 (42-65 vs. 38 (32-52), < 0.001], SOFA [3.3 (2.26-5.00) vs. 0.66 (0.06-2.29), < 0.001] and NAS [90 (75-95) vs. 97 (91-103), < 0.001]-when compared to patients without kidney damage.
CONCLUSIONS
The SAPS III, SOFA and NAS prognostic scoring systems showed good predictive capacity for acute kidney injury in critically ill patients. This study was not registered.
背景
众多预后评分系统已被开发并应用于重症监护领域；然而，由于急性肾损伤重症患者群体的特征，这些评分系统在该群体中的适用性和有效性可能存在差异。
目的
评估简化急性生理学评分系统III（SAPS III）、序贯性脓毒症相关器官衰竭评估（SOFA）和护理活动评分（NAS）预后评分系统对重症患者急性肾损伤的预测能力。
方法
对141例重症监护患者进行队列、前瞻性和定量研究，并进行随访。使用问卷收集有关预后评分系统预测急性肾损伤能力的信息。采用曼-惠特尼检验、克鲁斯卡尔-沃利斯检验和经邦费罗尼校正的曼-惠特尼检验，双侧P<0.05被认为具有统计学意义。
结果
结果显示，41.85%的患者在重症监护病房住院期间发生了急性肾损伤，与未发生肾损伤的患者相比，通过预后评分系统的中位数评估显示病情更严重——SAPS III[55（42-65）对38（32-52），P<0.001]、SOFA[3.3（2.26-5.00）对0.66（0.06-2.29），P<0.001]和NAS[90（75-95）对97（91-103），P<0.001]。
结论
SAPS III、SOFA和NAS预后评分系统对重症患者急性肾损伤具有良好的预测能力。本研究未注册。
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