Acute kidney injury is associated with increased hospital mortality after stroke.
Acute kidney injury is associated with increased hospital mortality after stroke.
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DOI：
10.1016/j.jstrokecerebrovasdis.2012.06.005
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发表时间：
2014-01
影响因子：
2.5
通讯作者：
Tirschwell, David L.
中科院分区：
文献类型：
--
作者：
Khatri, Minesh;Himmelfarb, Jonathan;Adams, Derk;Becker, Kyra;Longstreth, W. T.;Tirschwell, David L.
急性肾损伤（阿基）是常见的，并与不良的临床结果。关于阿基发生率和对卒中结局影响的信息有限。数据分析来自一个单一的学术医疗中心住院的缺血性卒中和脑出血（ICH）受试者的注册表。入院肌酐被视为基线。阿基定义为住院期间肌酐升高0.3 mg/dL或较基线升高至少50%。以住院死亡率为结果，对两种卒中类型建立多变量logistic回归模型。协变量包括性别、种族、年龄、入院时肌酐、入院时NIH卒中量表评分、头颈部对比增强CT扫描的表现和医学共病。缺血性卒中528例，死亡70例（13%），ICH 829例，死亡268例（32%）。平均年龄为64岁，其中56%为男性，71%为白人。阿基并发14%的缺血性卒中和21%的ICH住院。在按卒中类型分层的多变量分析中，阿基与缺血性卒中住院死亡率增加相关（比值比（OR）3.08，95%置信区间（CI）[1.49-6.35]），但非ICH（OR 0.82，95% CI [0.50-1.35]），但存活至少2天的患者除外（OR 2.11，95% CI [1.18-3.77]）。阿基经常发生在卒中后，并与住院死亡率增加相关。需要进一步的研究来确定这种关联是否是因果关系，以及预防阿基的措施是否会降低死亡率。
Acute kidney injury (AKI) is common and associates with poor clinical outcomes. Information about the incidence of AKI and effect on stroke outcomes is limited. Data were analyzed from a registry of subjects with ischemic stroke and intracerebral hemorrhage (ICH) hospitalized at a single academic medical center. Admission creatinine was considered to be the baseline. AKI was defined as a creatinine increase of 0.3 mg/dL or a percentage increase of at least 50% from baseline, occurring during hospitalization. Multivariate logistic regression models were created for both stroke types, with hospital mortality as the outcome. Covariates included gender, race, age, admission creatinine, admission NIH Stroke Scale score, performance of contrast-enhanced CT scan of the head and neck, and medical co-morbidities. There were 528 cases of ischemic stroke with 70 deaths (13%), and 829 cases of ICH with 268 deaths (32%). The mean age was 64 years, with 56% men and 71% whites. AKI complicated 14% of ischemic stroke and 21% of ICH hospitalizations. In multivariate analysis stratified by stroke type, AKI was associated with increased hospital mortality from ischemic stroke (odds ratio (OR) 3.08, 95% confidence interval (CI) [1.49–6.35]) but not ICH (OR 0.82, 95% CI [0.50–1.35]), except for those surviving at least two days (OR 2.11, 95% CI [1.18–3.77]). AKI occurs frequently after stroke and is associated with increased hospital mortality. Further studies are needed to establish if the association is causal and if measures to prevent AKI would result in decreased mortality.
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影响因子：
5.9
作者：
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DOI：
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