Major adverse kidney events within 30 days in patients with acute pancreatitis: a tertiary-center cohort study
Major adverse kidney events within 30 days in patients with acute pancreatitis: a tertiary-center cohort study
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急性胰腺炎患者 30 天内主要肾脏不良事件：一项三级中心队列研究
DOI：
10.1016/j.hpb.2021.05.012
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Li W
中科院分区：
文献类型：
--
作者：
Zhang X;Ye B;Mao W;Liu L;Li G;Zhou J;Zhang J;Guo J;Ke L;Tong Z;Li W
[背景]评价急性胰腺炎(AP)患者30天内主要不良肾脏事件(MAKE30)的发生率及其潜在危险因素。方法对2015年6月至2019年6月期间所有急性胰腺炎(AP)患者在腹痛发作后72小时内入院的资料进行回顾性分析。MAKE30-死亡、新的肾脏替代疗法(RRT)或持续性肾功能障碍(PRD)的复合体-及其单个成分在出院或30天时被回收。对MAKE30的危险因素进行Logistic回归分析。结果295例患者中有16%发生了MAKE30。就单个组成部分而言，死亡率为3%，新的RRT为15%，珠江三角洲为5%。多因素Logistic回归分析显示，入院时高氯血症[OR值=8.38(1.07~65.64)；P值=0.043]和SOFA评分[OR1.63(1.18~2.26)；P值=0.003]是预测MAKE30的独立危险因素。进一步分析发现，高氯血症患者对RRT的需求更多(57%比10%，P<0.001)，更多的PRD(14%比4%，P=0.034)。高氯血症和入院时SOFA评分是MAKE30的两个独立危险因素。
BackgroundTo evaluate the event rate of major adverse kidney events within 30 days (MAKE30) in acute pancreatitis (AP) and its potential risk factors.MethodsA retrospective analysis of a tertiary center data on all AP patients admitted within 72 h after onset of abdominal pain between June 2015 and June 2019 was conducted. MAKE30 — a composite of death, new renal replacement therapy (RRT), or persistent renal dysfunction (PRD) — and its individual components were retrieved at discharge or 30 days. Logistic regression analysis was used to assess the risk factors for MAKE30.Results295 patients were enrolled and 16% experienced MAKE30. For individual components, the incidence was 3% for death, 15% for new RRT, and 5% for PRD. In multivariate logistic regression analysis, hyperchloremia at admission [OR = 8.38 (1.07–65.64); P = 0.043] and SOFA score [OR 1.63 (1.18–2.26); P = 0.003] were independent risk factors in predicting MAKE30. Further analysis showed that patients with hyperchloremia had more requirements of RRT (57% vs. 10%, P < 0.001), more PRD (14% vs. 4%, P = 0.034).ConclusionMAKE30 is a common event in AP patients. Hyperchloremia and SOFA score at admission were two independent risk factors for MAKE30.