Epidemiology of sepsis-associated acute kidney injury in critically ill patients: a multicenter, prospective, observational cohort study in South Korea

IF 8.8 1区医学 Q1 CRITICAL CARE MEDICINE

Critical Care Pub Date : 2024-11-24 DOI:10.1186/s13054-024-05167-9

Myung Jin Song, Yeonhoon Jang, Matthieu Legrand, Sunghoon Park, RyoungEun Ko, Gee Young Suh, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, Se Young Jung, Sung Yoon Lim

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引用次数: 0

Abstract

Despite the clinical importance of sepsis-associated acute kidney injury (SA-AKI), little is known about its epidemiology. We aimed to investigate the incidence and outcomes of SA-AKI, as well as the risk factors for mortality among patients with severe SA-AKI in critically ill patients. This secondary multicenter, observational, prospective cohort analysis of sepsis in South Korea evaluated patients aged ≥ 19 years admitted to intensive care units with a diagnosis of sepsis. The primary outcome was the incidence of SA-AKI, defined using the new consensus definition of the Acute Disease Quality Initiative 28 Workgroup. Secondary outcomes were in-hospital mortality and risk factors for in-hospital mortality. Between September 2019 and December 2022, 5100 patients were admitted to intensive care units with a diagnosis of sepsis, and 3177 (62.3%) developed SA-AKI. A total of 613 (19.3%), 721 (22.7%), and 1843 (58.0%) patients had stage 1, 2, and 3 SA-AKI, respectively. Severe SA-AKI (stages 2 and 3 combined) was associated with an increased risk of in-hospital mortality. Adherence to the fluid resuscitation component of the one-hour sepsis bundle was associated with a decreased risk of in-hospital mortality in severe SA-AKI (adjusted odds ratio, 0.62; 95% confidence interval, 0.48–0.79; P < 0.001). Of the patients admitted to the intensive care unit for sepsis, 62.3% developed SA-AKI. Severe SA-AKI was associated with an increased risk of mortality. Adherence to the fluid resuscitation component of the one-hour sepsis bundle can potentially improve outcomes in these patients.

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危重病人败血症相关急性肾损伤的流行病学：韩国一项多中心、前瞻性、观察性队列研究

尽管脓毒症相关急性肾损伤（SA-AKI）具有重要的临床意义，但人们对其流行病学却知之甚少。我们的目的是调查 SA-AKI 的发病率和结果，以及重症患者中严重 SA-AKI 患者的死亡风险因素。这项针对韩国脓毒症的二级多中心前瞻性队列观察分析评估了入住重症监护病房并被诊断为脓毒症的年龄≥19岁的患者。主要结果是SA-AKI的发生率，采用急性疾病质量倡议28工作组的新共识定义。次要结果是院内死亡率和院内死亡率的风险因素。在2019年9月至2022年12月期间，重症监护病房共收治了5100名诊断为脓毒症的患者，其中3177人（62.3%）出现了SA-AKI。分别有613名（19.3%）、721名（22.7%）和1843名（58.0%）患者出现1期、2期和3期SA-AKI。严重 SA-AKI（2 期和 3 期合并）与院内死亡风险增加有关。坚持一小时脓毒症捆绑疗法中的液体复苏部分与重症SA-AKI患者院内死亡风险的降低有关（调整后的几率比为0.62；95%置信区间为0.48-0.79；P < 0.001）。在因脓毒症入住重症监护室的患者中，62.3%出现了SA-AKI。严重的 SA-AKI 与死亡风险增加有关。坚持一小时脓毒症捆绑疗法中的液体复苏部分有可能改善这些患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical Care 医学-危重病医学

CiteScore

20.60

自引率

3.30%

发文量

348

审稿时长

1.5 months

期刊介绍： Critical Care is an esteemed international medical journal that undergoes a rigorous peer-review process to maintain its high quality standards. Its primary objective is to enhance the healthcare services offered to critically ill patients. To achieve this, the journal focuses on gathering, exchanging, disseminating, and endorsing evidence-based information that is highly relevant to intensivists. By doing so, Critical Care seeks to provide a thorough and inclusive examination of the intensive care field.