Changes in the incidence and outcome for early acute kidney injury in a cohort of Australian intensive care units.
Changes in the incidence and outcome for early acute kidney injury in a cohort of Australian intensive care units.
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DOI：
10.1186/cc5949
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
ANZICS Database Management Committee
中科院分区：
文献类型：
--
作者：
Bagshaw SM;George C;Bellomo R;ANZICS Database Management Committee
关于重症患者急性肾损伤（阿基）的发生率是否随时间发生变化的信息有限，其结局是否改善也存在争议。我们查询了澳大利亚新西兰重症监护协会成人患者数据库，以获得1996年1月1日至2005年12月31日期间所有入住20个澳大利亚重症监护室（ICU）≥ 24小时的成人数据。评估了与早期阿基相关的ICU入院的发病率和死亡率趋势。20个研究ICU共收治91，254例患者，其中4，754例阿基，估计粗累积发生率为5.2%（95%置信区间，5.1 - 5.4）。研究期间阿基的发生率增加，估计年增量为2.8%（95%置信区间，1.0 - 5.6，P = 0.04）。AKI患者的粗住院死亡率显著高于无AKI患者（42.7% vs 13.4%;比值比4.8; 95%置信区间4.5 - 5.1; P < 0.0001）。阿基粗死亡率也有所下降（年百分比变化，-3.4%; 95%置信区间，-4.7至-2.12; P < 0.001），然而，这在无阿基的患者中没有观察到。协变量校正后，阿基仍与较高的死亡率相关（比值比，1.23; 95%置信区间，1.14 - 1.32; P < 0.001），住院死亡率的比值比呈下降趋势。在过去的十年中，在20个澳大利亚ICU收治的危重患者的大型队列中，早期阿基的发病率显著上升，而与阿基相关的死亡率下降。
There is limited information on whether the incidence of acute kidney injury (AKI) in critically ill patients has changed over time and there is controversy on whether its outcome has improved. We interrogated the Australian New Zealand Intensive Care Society Adult Patient Database to obtain data on all adult admissions to 20 Australian intensive care units (ICUs) for ≥ 24 hours from 1 January 1996 to 31 December 2005. Trends in incidence and mortality for ICU admissions associated with early AKI were assessed. There were 91,254 patient admissions to the 20 study ICUs, with 4,754 cases of AKI, for an estimated crude cumulative incidence of 5.2% (95% confidence interval, 5.1 to 5.4). The incidence of AKI increased during the study period, with an estimated annual increment of 2.8% (95% confidence interval, 1.0 to 5.6, P = 0.04). The crude hospital mortality was significantly higher for patients with AKI than those without (42.7% versus 13.4%; odds ratio, 4.8; 95% confidence interval, 4.5 to 5.1; P < 0.0001). There was also a decrease in AKI crude mortality (annual percentage change, -3.4%; 95% confidence interval, -4.7 to -2.12; P < 0.001), however, which was not seen in patients without AKI. After covariate adjustment, AKI remained associated with a higher mortality (odds ratio, 1.23; 95% confidence interval, 1.14 to 1.32; P < 0.001) and there was a declining trend in the odds ratio for hospital mortality. Over the past decade, in a large cohort of critically ill patients admitted to 20 Australian ICUs, there has been a significant rise in the incidence of early AKI while the mortality associated with AKI has declined.
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影响因子：
168.9
作者：
Ronco, C;Bellomo, R;La Greca, G
通讯作者：
La Greca, G
影响因子：
38.9
作者：
de Mendonça, A;Vincent, JL;Cantraine, F
通讯作者：
Cantraine, F
影响因子：
8.8
作者：
Metnitz, PGH;Krenn, CG;Druml, W
通讯作者：
Druml, W
影响因子：
13.2
作者：
Morgera, S;Kraft, AK;Neumayer, HH
通讯作者：
Neumayer, HH
影响因子：
13.3
作者：
Metcalfe, W;Simpson, M;MacLeod, AM
通讯作者：
MacLeod, AM