Outcomes Among Patients Hospitalized With COVID-19 and Acute Kidney Injury.
Outcomes Among Patients Hospitalized With COVID-19 and Acute Kidney Injury.
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DOI：
10.1053/j.ajkd.2020.09.002
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Northwell Nephrology COVID-19 Research Consortium
中科院分区：
文献类型：
--
作者：
Ng JH;Hirsch JS;Hazzan A;Wanchoo R;Shah HH;Malieckal DA;Ross DW;Sharma P;Sakhiya V;Fishbane S;Jhaveri KD;Northwell Nephrology COVID-19 Research Consortium
2019年冠状病毒病(新冠肺炎)和急性肾损伤(AKI)住院患者的预后尚不清楚。这项研究的目的是调查这些患者的存活率和肾脏预后。回顾性队列研究。2020年3月1日至2020年4月27日期间，使用新冠肺炎在纽约大都会13家医院住院的患者(年龄18岁)，进行了随访，直到出院。阿琪。主要结果：住院死亡。次要结果：出院时需要透析，肾功能恢复。单变量和多变量的事件间隔时间分析和Logistic回归。在收治的9,657例新冠肺炎患者中，急性心肌梗死的发生率为38.4/1,000病例日。无AKI、AKI不需要透析(AKI分期1-3)和AKI接受透析(AKI 3D)患者的住院死亡率分别为10.8、31.1和37.5/1000病人日。以无AKI的患者为参照组，我们观察到AKI 1-3和AKI 3D患者的住院死亡风险较高(R值分别为5.6[95%CI，5.0-6.3]和11.3[95%CI，9.6-13.1])。在调整了人口统计学、合并症和疾病严重程度后，与没有AKI的患者相比，AKI 1-3(调整后的HR，3.4[95%CI，3.0-3.9])和AKI 3D(调整后的HR，6.4[95%CI，5.5-7.6])的死亡风险仍然更高。在存活的AKI 1-3级患者中，74.1%的患者在出院时实现了肾脏恢复。在存活的AKI 3D患者中，30.6%的患者出院时仍需透析，院前慢性肾脏疾病是唯一与出院时需要透析相关的独立危险因素(调整后的OR，9.3[95%CI，2.3-37.8])。观察性回顾研究，仅限于新冠肺炎大流行高峰期的纽约大都市区。住院新冠肺炎患者的AKI与显著的死亡风险相关。
Outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) are not well understood. The goal of this study was to investigate the survival and kidney outcomes of these patients. Retrospective cohort study. Patients (aged ≥18 years) hospitalized with COVID-19 at 13 hospitals in metropolitan New York between March 1, 2020, and April 27, 2020, followed up until hospital discharge. AKI. Primary outcome: in-hospital death. Secondary outcomes: requiring dialysis at discharge, recovery of kidney function. Univariable and multivariable time-to-event analysis and logistic regression. Among 9,657 patients admitted with COVID-19, the AKI incidence rate was 38.4/1,000 patient-days. Incidence rates of in-hospital death among patients without AKI, with AKI not requiring dialysis (AKI stages 1-3), and with AKI receiving dialysis (AKI 3D) were 10.8, 31.1, and 37.5/1,000 patient-days, respectively. Taking those without AKI as the reference group, we observed greater risks for in-hospital death for patients with AKI 1-3 and AKI 3D (HRs of 5.6 [95% CI, 5.0-6.3] and 11.3 [95% CI, 9.6-13.1], respectively). After adjusting for demographics, comorbid conditions, and illness severity, the risk for death remained higher among those with AKI 1-3 (adjusted HR, 3.4 [95% CI, 3.0-3.9]) and AKI 3D (adjusted HR, 6.4 [95% CI, 5.5-7.6]) compared with those without AKI. Among patients with AKI 1-3 who survived, 74.1% achieved kidney recovery by the time of discharge. Among those with AKI 3D who survived, 30.6% remained on dialysis at discharge, and prehospitalization chronic kidney disease was the only independent risk factor associated with needing dialysis at discharge (adjusted OR, 9.3 [95% CI, 2.3-37.8]). Observational retrospective study, limited to the NY metropolitan area during the peak of the COVID-19 pandemic. AKI in hospitalized patients with COVID-19 was associated with significant risk for death.
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DOI：
10.1186/cc11454
发表时间：
2013-02-04
期刊：
Critical care (London, England)
影响因子：
--
作者：
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2020-01-01
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