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印度尼西亚巴东重症监护病房患者急性肾损伤预测评分的开发

Development of Acute Kidney Injury Predictor Score in Intensive Care Unit Patients in Padang, Indonesia.

作者信息

Kahar Liliriawati Ananta

机构信息

Department of Anesthesiology and Intensive Care, Faculty of Medicine, Andalas University, "Dr. M. Djamil" General Hospital, Padang, 25171, Indonesia.

出版信息

Acta Med Acad. 2024 Aug;53(2):136-145. doi: 10.5644/ama2006-124.454.

DOI:10.5644/ama2006-124.454
PMID:39639652
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11626242/
Abstract

OBJECTIVE

This study aims to develop and create a specialized acute kidney injury (AKI) predictor score for the intensive care unit (ICU) patients in Padang, Indonesia.

PATIENTS AND METHODS

This study was a prospective observational study on 352 ICU patients at three specialized hospitals in Padang City; Dr. M. Djamil General Hospital, Dr. Rasidin General Hospital, and Siti Rahmah Islamic Hospital. Data regarding demographics, clinical characteristics, laboratory results, and outcomes related to AKI were gathered. The factors that predict AKI were identified using multivariate logistic regression analysis to determine independent factors. The predictor scores were created using regression coefficients and then internally confirmed.

RESULTS

Out of a total of 352 patients, 128 individuals (36.4%) suffered from AKI. Factors that independently predict the occurrence of AKI include age over 60 years old, having a history of chronic kidney disease, having sepsis, need for vasopressors, and having creatinine level 1.3 mg/dL (IQR 1.0-1.8) upon admission to ICU. An area under the curve (AUC) of 0.85 (95% CI 0.80-0.90) indicated the strong performance of the constructed predictor score.

CONCLUSION

The constructed AKI predictor score a scale factor of 10, resulting in a range of 0-10 for the AKI predictor score. It demonstrates a good level of accuracy in predicting AKI in ICU patients in Padang. This score can be used by healthcare professionals to quickly identify and categorize individuals based on their risk level, facilitating timely intervention and personalized treatment.

摘要

目的

本研究旨在为印度尼西亚巴东重症监护病房(ICU)的患者开发并创建一种专门的急性肾损伤(AKI)预测评分系统。

患者与方法

本研究是一项对巴东市三家专科医院的352例ICU患者进行的前瞻性观察研究;M. 贾米尔博士综合医院、拉西丁博士综合医院和西蒂·拉赫玛伊斯兰医院。收集了有关人口统计学、临床特征、实验室检查结果以及与AKI相关的结局的数据。使用多因素逻辑回归分析确定预测AKI的因素,以确定独立因素。利用回归系数创建预测评分,然后进行内部验证。

结果

在总共352例患者中,128例(36.4%)患有AKI。独立预测AKI发生的因素包括年龄超过60岁、有慢性肾病病史、患有脓毒症、需要使用血管升压药以及入住ICU时肌酐水平为1.3 mg/dL(四分位间距1.0 - 1.8)。曲线下面积(AUC)为0.85(95%可信区间0.80 - 0.90)表明所构建的预测评分具有较强的性能。

结论

所构建的AKI预测评分系统的量表因子为10,AKI预测评分范围为0 - 10。它在预测巴东ICU患者的AKI方面显示出良好的准确性水平。医护人员可以使用该评分根据个体的风险水平快速识别并分类,便于及时干预和个性化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1066/11626242/9b18adea9158/AMA-53-136-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1066/11626242/d2a13ffe042c/AMA-53-136-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1066/11626242/9b18adea9158/AMA-53-136-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1066/11626242/d2a13ffe042c/AMA-53-136-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1066/11626242/9b18adea9158/AMA-53-136-g002.jpg

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Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational study.重症监护病房相关性脓毒症急性肾损伤:发生率、患者特征、时间、轨迹、治疗及相关结局。一项多中心、观察性研究。
Intensive Care Med. 2023 Sep;49(9):1079-1089. doi: 10.1007/s00134-023-07138-0. Epub 2023 Jul 11.
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Norepinephrine and Vasopressin in Hemorrhagic Shock: A Focus on Renal Hemodynamics.
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Int J Mol Sci. 2023 Feb 17;24(4):4103. doi: 10.3390/ijms24044103.
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Renal Microcirculation Injury as the Main Cause of Ischemic Acute Kidney Injury Development.肾微循环损伤是缺血性急性肾损伤发生发展的主要原因。
Biology (Basel). 2023 Feb 17;12(2):327. doi: 10.3390/biology12020327.
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Impact of Blood Loss on Renal Function and Interaction with Ischemia Duration after Nephron-Sparing Surgery.保肾手术后失血量对肾功能的影响及其与缺血时间的相互作用。
Curr Oncol. 2022 Dec 10;29(12):9760-9766. doi: 10.3390/curroncol29120767.
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The Pathophysiology of Sepsis-Associated AKI.脓毒症相关性急性肾损伤的病理生理学。
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