Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury
Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury
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DOI：
10.1017/s0007114521003111
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发表时间：
2021-08-16
影响因子：
3.6
通讯作者：
Sun, Jianping
中科院分区：
文献类型：
--
作者：
Li, Xunliang;Luan, Hong;Sun, Jianping
早期使用硫胺素对急性肾损伤（AKI）危重患者临床结果的影响尚不清楚。本研究的目的是调查早期硫胺素给药与 AKI 危重患者临床结果之间的关联。入ICU后48小时内发生AKI的危重患者数据来自重症监护医学信息集市III（MIMIC III）数据库。 PSM 用于将早期接受硫胺素治疗的患者与未早期接受硫胺素治疗的患者进行匹配。使用逻辑回归模型确定早期硫胺素使用与 AKI 导致的院内死亡率之间的关联。共有 15 066 名 AKI 患者符合研究纳入资格。经过倾向评分匹配（PSM）后，建立了734对早期接受和未接受硫胺素治疗的患者。早期使用硫胺素可降低院内死亡率（OR 0 中心点 65；95% CI 0 中心点 49、0 中心点 87；P < 0 中心点 001）和 90 天死亡率（OR 0 中心点 58；95% CI 0 中心点 45、0 中心点 74；P < 0 中心点 001），且与肾功能恢复相关（OR 1中心点26；95% CI 1中心点17、1中心点36；P < 0中心点001）。在亚组分析中，早期硫胺素给药与 1 至 2 期 AKI 患者较低的院内死亡率相关。早期使用硫胺素可改善 AKI 危重患者的短期生存率。根据肾脏疾病：改善全球结果标准，这可能对 1 至 2 期 AKI 患者产生有益作用。
The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0 center dot 65; 95 % CI 0 center dot 49, 0 center dot 87; P < 0 center dot 001) and 90-d mortality (OR 0 center dot 58; 95 % CI 0 center dot 45, 0 center dot 74; P < 0 center dot 001), and it was also associated with the recovery of renal function (OR 1 center dot 26; 95 % CI 1 center dot 17, 1 center dot 36; P < 0 center dot 001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.