Ye Chongyang, Zhu Chunyan, Hu Shijing, Mei Yulin, Yang Tianjun
Department of Critical Care Medicine, The First Affiliated Hospital of USTC, Division of life Sciences and Medicine, University of science and Technology of China, Hefei, Anhui Province, 230001, China.
Clin Exp Med. 2025 Jun 7;25(1):192. doi: 10.1007/s10238-025-01681-4.
Sepsis-induced acute kidney injury (SA-AKI) significantly increases mortality and healthcare burdens. Identifying key mortality risk factors is crucial for improving patient outcomes. This study aims to identify the primary factors affecting mortality in SA-AKI patients using the MIMIC-III database. A retrospective analysis was conducted on 4868 SA-AKI patients from the MIMIC-III database. Clinical data from the first 24 h of ICU admission were analyzed using logistic regression to identify mortality predictors. Key mortality predictors included advanced age (OR = 1.015, 95% CI: 1.006-1.024), severe AKI stages (OR = 1.470, 95% CI: 1.285-1.676), low serum albumin (OR = 0.606, 95% CI: 0.506-0.722), delayed antibiotics (OR = 1.001, 95% CI: 1.000-1.002), high AST (OR = 1.035, 95% CI: 1.027-1.083), and bilirubin (OR = 1.055, 95% CI: 1.037-1.083). The area under the curve (AUC) of the combined predictors for mortality risk was 0.796, indicating high predictive accuracy. Conclusions: Early intervention and monitoring of identified risk factors such as age, AKI stage, albumin levels, and antibiotic timeliness can enhance survival rates in SA-AKI patients.
脓毒症诱导的急性肾损伤(SA-AKI)显著增加死亡率和医疗负担。识别关键的死亡风险因素对于改善患者预后至关重要。本研究旨在使用MIMIC-III数据库确定影响SA-AKI患者死亡率的主要因素。对来自MIMIC-III数据库的4868例SA-AKI患者进行了回顾性分析。使用逻辑回归分析重症监护病房(ICU)入院后最初24小时的临床数据,以确定死亡预测因素。关键的死亡预测因素包括高龄(OR = 1.015,95%置信区间:1.006 - 1.024)、严重急性肾损伤阶段(OR = 1.470,95%置信区间:1.285 - 1.676)、低血清白蛋白(OR = 0.606,95%置信区间:0.506 - 0.722)、抗生素延迟使用(OR = 1.001,95%置信区间:1.000 - 1.002)、高AST(OR = 1.035,95%置信区间:1.027 - 1.083)和胆红素(OR = 1.055,95%置信区间:1.037 - 1.083)。死亡风险联合预测指标的曲线下面积(AUC)为0.796,表明预测准确性较高。结论:对已识别的风险因素如年龄、急性肾损伤阶段、白蛋白水平和抗生素使用及时性进行早期干预和监测,可以提高SA-AKI患者的生存率。