Predictors and Outcomes of Acute Kidney Injury in Intracerebral Hemorrhage Patients: Evidence from a Large-Scale National Database Analysis.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2025-03-28 DOI:10.1097/SHK.0000000000002577

Binbin Tian, Xuanhe Tang, Linling He, Junfen Cheng, Jian Wang, Silin Liang, Junde Mo, Chunbo Chen

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引用次数: 0

Abstract

Background: Acute kidney injury (AKI) is a significant complication in patients with intracerebral hemorrhage (ICH). This study sought to explore the incidence, risk factors, and outcomes of AKI in ICH patients using a comprehensive national database.

Methods: Data from the Nationwide Inpatient Sample database (2010-2019) were analyzed. This analysis compared demographics, comorbidities, complications, mortality, and healthcare utilization between ICH patients who developed AKI and those who did not. Multivariate logistic regression was used to identify risk factors for AKI and assess their impact on in-hospital outcomes.

Results: The incidence of AKI among ICH patients increased from 10.7% in 2010 to 19.6% by 2019, yielding an overall incidence rate of 15%. Risk factors included, Black race, comorbidities (≥ 3), teaching hospital setting, and specific pre-existing conditions such as heart failure, coagulopathy, diabetes, fluid and electrolyte disorders, other neurological disorders, obesity, paralysis, chronic kidney disease excluding ESRD, peptic ulcer disease (without bleeding), and weight loss. Conversely, female sex and elective admissions acted as protective factors. AKI-related in-hospital complications encompassed acute myocardial infarction, pneumonia, sepsis, cardiac arrest, respiratory failure, and mechanical ventilation. AKI was associated with higher in-hospital mortality (26.9% vs. 18.5%), prolonged hospital stays (median duration of 9 days vs. 5 days for non-AKI patients) and increased requirement for dialysis (3.1% vs. 0.0%). Healthcare costs were significantly elevated, with median charges doubling for AKI patients.

Conclusion: AKI is a frequent and severe complication among patients with ICH, markedly influencing clinical outcomes and healthcare resource utilization. Early identification of high-risk patients and implementation of effective preventive strategies are critical to enhance patient management and outcomes.

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脑出血患者急性肾损伤的预测因素和结果：来自大规模国家数据库分析的证据。

背景：急性肾损伤（AKI）是脑出血（ICH）患者的重要并发症。本研究旨在通过一个全面的国家数据库探讨脑出血患者AKI的发生率、危险因素和结局。方法：对2010-2019年全国住院患者样本数据库数据进行分析。该分析比较了脑出血患者发生AKI和未发生AKI的患者之间的人口统计学、合并症、并发症、死亡率和医疗保健利用情况。采用多变量logistic回归来确定AKI的危险因素并评估其对院内预后的影响。结果：ICH患者AKI发病率从2010年的10.7%上升到2019年的19.6%，总发病率为15%。危险因素包括：黑人种族、合并症（≥3）、教学医院环境和特定的既往疾病，如心力衰竭、凝血功能障碍、糖尿病、液体和电解质紊乱、其他神经系统疾病、肥胖、瘫痪、慢性肾脏疾病（不包括ESRD）、消化性溃疡疾病（无出血）和体重减轻。相反，女性的性别和选择性录取是保护因素。aki相关的院内并发症包括急性心肌梗死、肺炎、败血症、心脏骤停、呼吸衰竭和机械通气。AKI与较高的住院死亡率（26.9% vs. 18.5%）、住院时间延长（中位住院时间为9天vs.非AKI患者为5天）和透析需求增加（3.1% vs. 0.0%）相关。医疗费用显著升高，AKI患者的中位数费用翻了一番。结论：AKI是脑出血患者常见且严重的并发症，严重影响脑出血患者的临床预后和医疗资源利用。早期识别高危患者和实施有效的预防策略对于加强患者管理和结果至关重要。

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

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.