HOSPITAL-ACQUIRED RENAL-INSUFFICIENCY - A PROSPECTIVE-STUDY
HOSPITAL-ACQUIRED RENAL-INSUFFICIENCY - A PROSPECTIVE-STUDY
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DOI：
10.1016/0002-9343(83)90618-6
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发表时间：
1983-01-01
影响因子：
5.9
通讯作者：
HARRINGTON, JT
中科院分区：
文献类型：
--
作者：
HOU, SH;BUSHINSKY, DA;HARRINGTON, JT
前瞻性地评估连续的内科和外科住院（2262例），以确定医源性因素对医院肾功能不全发展的贡献。在2216例有风险的患者中，4.9%发生了一定程度的肾功能不全。肾灌注减少、术后肾功能不全、放射造影剂和氨基糖苷类占79%。广义的医源性因素占所有发作的55%。预后不良的指标包括少尿、尿沉渣异常和最重要的肾功能不全的严重程度;血清肌酐增加≥3 mg/dl时，死亡率为64%。年龄、入院时血清肌酐水平和肾功能不全发作次数对结局无显著影响。显然，在医院中发生肾衰竭的风险很大，由于医院获得性肾功能不全的死亡率仍然很高。
Consecutive medial and surgical admissions (2262) were evaluated prospectively to determine the contribution of iatrogenic factors to the development of renal insufficiency in hospital. Of 2216 patients at risk, some degree of renal insufficiency developed in 4.9%. Decreased renal perfusion, postoperative renal insufficiency, radiographic contrast media and aminoglycosides accounted for 79% of the episodes. Iatrogenic factors, broadly defined, accounted for 55% of all episodes. Poor prognostic indicators included oliguria, urine sediment abnormalities and, most importantly, severity of renal insufficiency; with an increase in serum creatinine of .gtoreq. 3 mg/dl, the mortality rate was 64%. Age, admission serum creatinine levels and the number of episodes of renal insufficiency did not significantly affect outcome. Apparently, there is a substantial risk of the development of renal failure in hospital and the mortality rate due to hospital-acquired renal insufficiency remains high.