RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis.
RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis.
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急性肾脏损伤的步枪标准与重症患者的医院死亡率有关：一项队列分析。
DOI：
10.1186/cc4915
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发表时间：
2006
期刊：
影响因子：
15.1
通讯作者：
Kellum, John A.
中科院分区：
文献类型：
--
作者：
Hoste, Eric A. J.;Clermont, Gilles;Kersten, Alexander;Venkataraman, Ramesh;Angus, Derek C.;De Bacquer, Dirk;Kellum, John A.
急性肾损伤缺乏标准定义，导致报告的发病率和相关死亡率差异很大。步枪是一种新开发的急性肾损伤国际共识分类，定义了三个严重程度等级-风险（R级），损伤（I级）和失败（F级）-但尚未在临床系列中进行评估。我们在一个三级护理学术中心的7个重症监护病房对一年期间（2000年7月1日至2001年6月30日）收治的5，383例患者进行了回顾性队列研究。67%的重症监护病房患者发生急性肾损伤，最大步枪R级、I级和F级分别为12%、27%和28%。在达到风险水平的1，510例患者（28%）中，840例（56%）进展。最大步枪R级、I级和F级患者的住院死亡率分别为8.8%、11.4%和26.3%，而无急性肾损伤患者的住院死亡率为5.5%。此外，急性肾损伤（风险比，1.7; 95%置信区间，1.28-2.13; P < 0.001）和最大步枪I级（风险比，1.4; 95%置信区间，1.02-1.88; P = 0.037）和F级（风险比，2.7; 95%可信区间，2.03-3.55; P < 0.001）与调整多个协变量后的住院死亡率相关。在这个普通重症监护室人群中，急性肾脏“风险、损伤、衰竭”（由新开发的步枪分类定义）与医院死亡率和资源使用增加相关。步枪R级患者确实处于进展为I级或F级的高风险中。与未进展超过R级或从未发生急性肾损伤的患者相比，步枪I级或F级患者的住院时间显著延长，住院死亡风险增加，即使在调整基线疾病严重程度、病例组合、种族、性别和年龄后也是如此。
The lack of a standard definition for acute kidney injury has resulted in a large variation in the reported incidence and associated mortality. RIFLE, a newly developed international consensus classification for acute kidney injury, defines three grades of severity – risk (class R), injury (class I) and failure (class F) – but has not yet been evaluated in a clinical series. We performed a retrospective cohort study, in seven intensive care units in a single tertiary care academic center, on 5,383 patients admitted during a one year period (1 July 2000–30 June 2001). Acute kidney injury occurred in 67% of intensive care unit admissions, with maximum RIFLE class R, class I and class F in 12%, 27% and 28%, respectively. Of the 1,510 patients (28%) that reached a level of risk, 840 (56%) progressed. Patients with maximum RIFLE class R, class I and class F had hospital mortality rates of 8.8%, 11.4% and 26.3%, respectively, compared with 5.5% for patients without acute kidney injury. Additionally, acute kidney injury (hazard ratio, 1.7; 95% confidence interval, 1.28–2.13; P < 0.001) and maximum RIFLE class I (hazard ratio, 1.4; 95% confidence interval, 1.02–1.88; P = 0.037) and class F (hazard ratio, 2.7; 95% confidence interval, 2.03–3.55; P < 0.001) were associated with hospital mortality after adjusting for multiple covariates. In this general intensive care unit population, acute kidney 'risk, injury, failure', as defined by the newly developed RIFLE classification, is associated with increased hospital mortality and resource use. Patients with RIFLE class R are indeed at high risk of progression to class I or class F. Patients with RIFLE class I or class F incur a significantly increased length of stay and an increased risk of inhospital mortality compared with those who do not progress past class R or those who never develop acute kidney injury, even after adjusting for baseline severity of illness, case mix, race, gender and age.
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影响因子：
13.2
作者：
Abosaif, NY;Tolba, YA;El Nahas, AM
通讯作者：
El Nahas, AM
影响因子：
6.1
作者：
Bell, M;Liljestam, E;Martling, CR
通讯作者：
Martling, CR
DOI：
10.1053/jarr.2002.35564
发表时间：
2002-10-01
期刊：
ADVANCES IN RENAL REPLACEMENT THERAPY
影响因子：
--
作者：
Kellum, JA
通讯作者：
Kellum, JA
影响因子：
39.2
作者：
Mangano, CM;Diamondstone, LS;Mangano, DT
通讯作者：
Mangano, DT
影响因子：
5.9
作者：
Chertow, GM;Levy, EM;Daley, J
通讯作者：
Daley, J