Subgroups of Patients with Distinct Health Utility Profiles after AKI.
Subgroups of Patients with Distinct Health Utility Profiles after AKI.
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DOI：
10.34067/kid.0000000000000201
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发表时间：
2023-07-01
期刊：
影响因子：
--
通讯作者：
Miaskowski C
中科院分区：
文献类型：
--
作者：
Kwong YD;Liu KD;Hsu CY;Cooper B;Palevsky PM;Kellum JA;Johansen KL;Miaskowski C
在阿基后60天可以确定健康效用特征。具有不同健康效用特征的患者亚组在指数住院和1年时的结局方面具有不同的特征。当考虑资源以改善阿基后患者的身体和情绪健康时，这些特征可能是有用的。阿基后的健康相关生活质量结局存在大量个体间差异。本研究旨在确定早期阿基幸存者的亚组是否可以根据阿基后60天确定的不同健康效用损害特征进行识别，以及这些亚组在首次住院时的临床和生物标志物特征以及1年随访时的结局是否不同。这项回顾性分析使用了来自肾脏恢复生物标志物研究的数据，这是急性肾衰竭试验网络研究的一个观察性子队列。在阿基后存活60天的402名患者中，338名完成了健康效用指数3调查，该调查测量了八项健康属性的损害。潜在类别分析用于识别具有不同健康效用特征的患者亚组。确定了具有不同健康效用损害特征的三个亚组：低（28%的参与者），中度（58%）和高（14%），阿基后60天的八个健康属性中位损害分别为1，4和6。患者亚组在体重、脑血管病史、透析强度、住院时间和透析依赖性方面存在差异。三个亚组之间在首次住院时的血清肌酐和血尿素氮没有差异。在研究第1天，高度损伤亚组的IL-6和可溶性TNF受体2水平较高。三个亚组的1年死亡率不同：低损伤亚组为5%，中度亚组为21%，高度亚组为52%。在阿基后60天，可以确定具有不同健康效用损害特征的患者亚组。这些亚组在首次住院时具有不同的特征。60天时损伤程度越高，生存率越低。
Health utility profiles can be identified at 60 days after AKI. Patient subgroups with distinct health utility profiles have different characteristics at index hospitalization and outcomes at 1 year. These profiles may be useful when considering resources to improve the physical and emotional health of patients after AKI. A large amount of interindividual variability exists in health-related quality of life outcomes after AKI. This study aimed to determine whether subgroups of early AKI survivors could be identified on the basis of distinct health utility impairment profiles ascertained at 60 days after AKI and whether these subgroups differed in clinical and biomarker characteristics at index hospitalization and outcomes at 1-year follow-up. This retrospective analysis used data from the Biologic Markers of Renal Recovery for the Kidney study, an observational subcohort of the Acute Renal Failure Trial Network study. Of 402 patients who survived to 60 days after AKI, 338 completed the Health Utility Index 3 survey, which measures impairments in eight health attributes. Latent class analysis was used to identify subgroups of patients with distinct health utility profiles. Three subgroups with distinct health utility impairment profiles were identified: Low (28% of participants), Moderate (58%), and High (14%) with a median of one, four, and six impairments across the eight health attributes at 60 days after AKI, respectively. Patient subgroups differed in weight, history of cerebrovascular disease, intensity of dialysis, hospital length of stay, and dialysis dependence. Serum creatinine and blood urea nitrogen at index hospitalization did not differ among the three subgroups. The High impairment subgroup had higher levels of IL-6 and soluble TNF receptor 2 at study day 1. The three subgroups had different 1-year mortality rates: 5% in the Low, 21% in the Moderate, and 52% in the High impairment subgroup. Patient subgroups with distinct health utility impairment profiles can be identified 60 days after AKI. These subgroups have different characteristics at index hospitalization. A higher level of impairment at 60 days was associated with decreased survival.
影响因子：
2.5
作者：
Moughrabi S;Evangelista LS;Habib SI;Kassabian L;Breen EC;Nyamathi A;Irwin M
通讯作者：
Irwin M