African American race, obesity, and blood product transfusion are risk factors for acute kidney injury in critically ill trauma patients.
African American race, obesity, and blood product transfusion are risk factors for acute kidney injury in critically ill trauma patients.
复制标题
DOI：
10.1016/j.jcrc.2012.02.002
复制
发表时间：
2012-10
影响因子：
3.7
通讯作者：
Christie, Jason D.
中科院分区：
文献类型：
--
作者：
Shashaty, Michael G. S.;Meyer, Nuala J.;Localio, A. Russell;Gallop, Robert;Bellamy, Scarlett L.;Holena, Daniel N.;Lanken, Paul N.;Kaplan, Sandra;Yarar, Dilek;Kawut, Steven M.;Feldman, Harold I.;Christie, Jason D.
急性肾损伤(AKI)是创伤后常见的发病率来源。我们试图根据急性肾损伤网络(AKIN)标准，在危重创伤患者中确定AKI的新危险因素。对400名住进一级创伤中心ICU的患者进行了前瞻性队列研究，跟踪研究了5天内AKI的发展。AKI发生率为36.8%(147/400)。多因素回归分析显示，非裔美国人种族(OR1.86；95%CI 1.08，3.18；p=0.024)、体重指数≥30(OR4.72vs正常体重指数，95%CI2.59，8.61，p<；0.001)、糖尿病(OR3.26；95%CI 1.30，8.20；p=0.012)、腹部缩短性损伤评分≥4(OR3.78；95%CI 1.79，7.96；p<；；0.001)，复苏期间给予不匹配的压缩红细胞(OR1.13/单位；95%可信区间1.04，1.23；p=0.004)。与第1、2和3期相似的患者的住院死亡率分别为9.8%、13.7%和30.4%，而非急性心肌梗死患者的住院死亡率为3.8%(p<；0.001)。危重创伤患者的AKI与大量死亡率有关。非裔美国人种族、肥胖和血液制品管理作为AKI的独立危险因素的研究结果值得进一步研究，以阐明潜在的机制。
Acute kidney injury (AKI) is a common source of morbidity after trauma. We sought to determine novel risk factors for AKI, by Acute Kidney Injury Network (AKIN) criteria, in critically ill trauma patients. Prospective cohort study of 400 patients admitted to the ICU of a level one trauma center, followed for development of AKI over five days. AKI developed in 147/400 (36.8%) patients. In multivariable regression analysis, independent risk factors for AKI included African American race (OR 1.86; 95% CI 1.08,3.18; p=0.024), body mass index ≥30 (OR 4.72 versus normal BMI, 95% CI 2.59, 8.61, p<0.001), diabetes mellitus (OR 3.26; 95% CI 1.30,8.20; p=0.012), abdominal Abbreviated Injury Scale score ≥4 (OR 3.78; 95% CI 1.79,7.96; p<0.001), and unmatched packed red blood cells administered during resuscitation (OR 1.13 per unit; 95% CI 1.04,1.23; p=0.004). AKIN stages 1, 2, and 3 were associated with hospital mortality rates of 9.8%, 13.7%, and 30.4%, respectively, compared with 3.8% for those without AKI (p<0.001). AKI in critically ill trauma patients is associated with substantial mortality. The findings of African American race, obesity, and blood product administration as independent risk factors for AKI deserve further study to elucidate underlying mechanisms.
登录
查看更多内容
影响因子：
38.9
作者：
Druml, Wilfred;Metnitz, Barbara;Metnitz, Philipp G. H.
通讯作者：
Metnitz, Philipp G. H.
DOI：
10.1126/science.1193032
发表时间：
2010-08-13
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Genovese G;Friedman DJ;Ross MD;Lecordier L;Uzureau P;Freedman BI;Bowden DW;Langefeld CD;Oleksyk TK;Uscinski Knob AL;Bernhardy AJ;Hicks PJ;Nelson GW;Vanhollebeke B;Winkler CA;Kopp JB;Pays E;Pollak MR
通讯作者：
Pollak MR
DOI：
10.1016/j.jamcollsurg.2007.09.011
发表时间：
2008-03-01
影响因子：
5.2
作者：
Brown, Carlos V. R.;Dubose, Joseph J.;Demetriades, Demetrios
通讯作者：
Demetriades, Demetrios
DOI：
10.1097/00005373-199112000-00003
发表时间：
1991-12-01
影响因子：
--
作者：
MORRIS, JA;MUCHA, P;BASS, SM
通讯作者：
BASS, SM
影响因子：
3.8
作者：
Wyatt, CM;Arons, RR;Klotman, ME
通讯作者：
Klotman, ME