Nina Fischer, Xinfei Miao, Danielle Weck, Jacob Matalon, Cameron C Neeki, Troy Pennington, Fanglong Dong, Sarkis Arabian, Michael M Neeki
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引用次数: 0
Abstract
Background: The recent global pandemic due to severe acute respiratory syndrome coronavirus-2 resulted in a high rate of multi-organ failure and mortality in a large patient population across the world. As such, a possible correlation between acute kidney injury (AKI) and increased mortality rate in these patients has been suggested in literature.
Methods: This is a two-year retrospective study of critically ill adult patients infected with COVID-19 that were admitted to the intensive care unit (ICU) on ventilatory support. Two groups of patients were identified in this study, those who were directly admitted to the ICU or those who were initially admitted to the Medical Floor and were later transferred to the ICU due to either worsening respiratory status or change in their hemodynamic conditions. Within each group, three subgroups were created based on the status of AKI, namely, those who did not develop AKI, those who developed AKI, and those who with previous history of dialysis dependent AKI.
Results: The AKI subgroup had the highest mortality rate in the ICU and Floor patients. Of note, those patients who were directly admitted to the Floor and were later transferred to the ICU for worsening conditions also experienced a higher mortality rate if they had developed AKI during their course of hospital stay.
Conclusions: This study identified a statistically significant higher mortality in patients who developed AKI than those who did not develop AKI among critically ill patients.
Trial registration: Clinicaltrials.gov registration number NCT05964088. Date of registration: July 24 2023.
背景：最近由严重急性呼吸系统综合征冠状病毒-2引起的全球大流行导致全球大量患者出现多器官功能衰竭，死亡率居高不下。因此，有文献认为急性肾损伤（AKI）与这些患者的死亡率增加之间可能存在关联：这是一项为期两年的回顾性研究，研究对象是感染 COVID-19 并进入重症监护室（ICU）接受呼吸机支持治疗的成年重症患者。本研究确定了两组患者，一组是直接入住重症监护室的患者，另一组是最初入住内科楼层，后因呼吸状况恶化或血液动力学状况改变而转入重症监护室的患者。在每组患者中，根据 AKI 状态分为三个亚组，即未发生 AKI 者、发生 AKI 者和既往有透析依赖性 AKI 病史者：AKI 亚组的重症监护室和楼层患者死亡率最高。值得注意的是，那些直接入住楼层病房，后因病情恶化转入重症监护室的患者，如果在住院期间发生了 AKI，死亡率也会更高：本研究发现，在危重病人中，发生 AKI 的病人死亡率明显高于未发生 AKI 的病人：试验注册：Clinicaltrials.gov 注册号 NCT05964088。注册日期：2023 年 7 月 24 日：2023年7月24日。
期刊介绍：
The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.
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