Trends in the Incidence of Acute Kidney Injury in Patients Hospitalized With Acute Myocardial Infarction
Trends in the Incidence of Acute Kidney Injury in Patients Hospitalized With Acute Myocardial Infarction
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DOI：
10.1001/archinternmed.2011.1202
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发表时间：
2012-02-13
影响因子：
--
通讯作者：
Kosiborod, Mikhail
中科院分区：
文献类型：
--
作者：
Amin, Amit P.;Salisbury, Adam C.;Kosiborod, Mikhail
背景资料：急性肾损伤（阿基）在急性心肌梗死（AMI）患者中很常见，并与永久性肾损伤和死亡有关。虽然越来越多的指南强调阿基的预防，提高认识是否转化为降低阿基率尚不清楚。方法：在33249连续住院31532例AMI患者在56个美国中心从Cerner公司的HealthFacts数据库，我们研究了阿基发病率的时间趋势，从2000年至2008年。急性肾损伤定义为住院期间肌酐水平绝对升高至少0.3 mg/dL或相对升高至少50%。从2000年到2008年，患者的平均年龄增加（从66.5岁到68.6岁），已知的阿基风险因素也是如此，包括慢性肾脏疾病、心源性休克、糖尿病、心力衰竭，冠状动脉造影和经皮冠状动脉介入治疗。尽管如此，阿基的发病率从2000年的26.6%下降到2008年的19.7%（P
Background: Acute kidney injury (AKI) is common in patients with acute myocardial infarction (AMI) and is associated with permanent renal impairment and death. Although guidelines increasingly emphasize AKI prevention, whether increased awareness has translated into reduced AKI rates is unclear.Methods: Among 33 249 consecutive hospitalizations in 31 532 unselected patients with AMI across 56 US centers from Cerner Corporation's HealthFacts database, we examined the temporal trends in AKI incidence from 2000 to 2008. Acute kidney injury was defined as an absolute increase in creatinine level of at least 0.3 mg/dL or a relative increase of at least 50% during hospitalization.Results: From 2000 to 2008, the mean age of patients increased (from 66.5 to 68.6 years), as did the known AKI risk factors, including chronic kidney disease, cardiogenic shock, diabetes mellitus, heart failure, coronary angiography, and percutaneous coronary intervention. Despite this, AKI incidence declined from 26.6% in 2000 to 19.7% in 2008 (P