Hua Yiming, Ding Ning, Jing Huaizhi, Xie Yifei, Wu Hao, Wu Yue, Lan Beidi
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Key Laboratory of Molecular Cardiology, Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Endocrinol (Lausanne). 2024 Dec 23;15:1462330. doi: 10.3389/fendo.2024.1462330. eCollection 2024.
The Sequential Organ Failure Assessment (SOFA) score is a widely utilized clinical tool for evaluating the severity of organ failure in critically ill patients and assessing their condition and prognosis in the intensive care unit (ICU). Research has demonstrated that higher SOFA scores are associated with poorer outcomes in these patients. However, the predictive value of the SOFA score for acute kidney injury (AKI), a common complication of diabetic ketoacidosis (DKA), remains uncertain. Therefore, this study aims to investigate the relationship between SOFA scores and the incidence of AKI in patients with DKA.
The study population was divided into two groups based on the median SOFA score (Q1: SOFA ≤3; Q2: SOFA >3). The primary endpoint was the incidence of AKI in patients with DKA. Secondary endpoints included renal replacement therapy (RRT) utilization and in-hospital mortality. Kaplan-Meier survival analysis, Cox proportional hazards models, and logistic regression models were employed to assess the association between SOFA and therisk of AKI in patients with DKA.
Overall, 626 patients with DKA were included in this study, of which 335 (53%) were male. Kaplan-Meier survival analysis included that patients with higher SOFA scores experienced significantly increased cumulative incidences of AKI, higher rates of RRT utilization, and elevated in-hospital mortality. Furthermore, after adjusting for confounding factors, logistic regression and Cox proportional hazards analyses confirmed that SOFA scores remained significantly associated with the incidence of AKI in patients with DKA.
Our study indicates that a high SOFA score is an independent risk predictor for the occurrence of AKI, the utilization of RRT, and in-hospital mortality in patients with DKA. The sofa score can be utilized as a biomarker to assess the risk of AKI in this patient population.
序贯器官衰竭评估（SOFA）评分是一种广泛应用的临床工具，用于评估危重病患者器官衰竭的严重程度，并在重症监护病房（ICU）中评估他们的病情和预后。研究表明，较高的SOFA评分与这些患者较差的预后相关。然而，SOFA评分对糖尿病酮症酸中毒（DKA）的常见并发症急性肾损伤（AKI）的预测价值仍不确定。因此，本研究旨在探讨DKA患者中SOFA评分与AKI发生率之间的关系。
根据SOFA评分中位数将研究人群分为两组（Q1：SOFA≤3；Q2：SOFA>3）。主要终点是DKA患者中AKI的发生率。次要终点包括肾脏替代治疗（RRT）的使用和住院死亡率。采用Kaplan-Meier生存分析、Cox比例风险模型和逻辑回归模型来评估SOFA与DKA患者发生AKI风险之间的关联。
总体而言，本研究纳入了626例DKA患者，其中335例（53%）为男性。Kaplan-Meier生存分析表明，SOFA评分较高的患者发生AKI的累积发生率显著增加、RRT使用率较高且住院死亡率升高。此外，在调整混杂因素后，逻辑回归和Cox比例风险分析证实，SOFA评分仍与DKA患者AKI的发生率显著相关。
我们的研究表明，高SOFA评分是DKA患者发生AKI、使用RRT和住院死亡的独立风险预测因素。SOFA评分可作为评估该患者群体发生AKI风险的生物标志物。
