Chronic obstructive pulmonary disease is associated with a higher incidence of acute kidney injury in non-cardiac but not in cardiac surgery ICU-patients: a retrospective MIMIC-III database analysis

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-05-24 DOI:10.1016/j.rmed.2025.108160

Nadine Hochhausen , Ajay Moza , Andreas Kroh , Rolf Rossaint , Felix Kork

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引用次数: 0

Abstract

Purpose

Acute kidney injury (AKI) and chronic obstructive pulmonary disease (COPD) are both associated with high mortality. We hypothesized that COPD impacts the incidence of AKI and the outcome of surgical intensive care unit (ICU)-patients.

Materials and methods

We analyzed data of surgical ICU-patients from the Medical-Information-Mart-for-Intensive-Care-III-database. We compared the incidence of AKI, in-hospital-mortality, ICU-and hospital-length-of-stay (ICU-LOS, HLOS) in patients with and without COPD. In a subgroup analysis, we compared the outcomes of patients undergoing cardiac (CS) and non-cardiac surgery (NCS).

Results

The data of 21,720 cases were analyzed, 9.7 % suffered from COPD. COPD-patients were younger compared to patients without COPD (64years(52–75)vs.71years(63–78),p < 0.001). Males were more frequently represented in both groups (58.3 %vs.61.2 %,p = 0.009). COPD-patients had a higher incidence of AKI (24.2 %vs.19.7 %,p < 0.001), higher in-hospital-mortality (8.7 % vs.6.4 %,p < 0.001), longer ICU-LOS (3.1days(IQR,1.6–7.0)vs.2.3days(IQR,1.3–5.0),p < 0.001), and HLOS (10days(IQR,6–17)vs.8days(IQR,5–15),p < 0.001). Multivariable analyses could not confirm a higher risk for AKI in surgical COPD-patients but for all other outcomes (in-hospital mortality,OR:1.59,95 %CI:1.24–2.04,p < 0.001; ICU-LOS,beta:1.1, 95 %CI:0.6–2.3,p < 0.001; HLOS,beta:1.7,95 %CI:0.9–2.4,p < 0.001).

Subgroup analyses revealed that COPD was associated with a higher risk of AKI (OR,1.24,95 %CI:1.01–1.51,p = 0.038), longer ICU-LOS (beta:0.9,95 %CI:0.3–1.5,p = 0.006) and HLOS (beta:1.4,95 %CI:0.2–2.5,p = 0.018) but not with a higher risk for in-hospital mortality in NCS-patients. In CS-patients on the other hand, COPD was associated with a higher risk for in-hospital mortality (OR,1.73,95 %CI:1.02–2.94,p = 0.043) but neither for AKI, longer ICU-LOS or HLOS.

Conclusions

COPD has a different impact on outcomes in CS- and NCS-patients. While COPD was associated with a higher risk for in-hospital mortality in CS-patients, COPD was associated with a higher risk of AKI, longer ICU-LOS and HLOS in NCS-patients.

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慢性阻塞性肺疾病与非心脏而非心脏手术icu患者的急性肾损伤发生率较高相关：一项回顾性MIMIC-III数据库分析。

目的：急性肾损伤（AKI）和慢性阻塞性肺疾病（COPD）均与高死亡率相关。我们假设COPD影响AKI的发生率和外科重症监护病房（ICU）患者的预后。材料和方法：我们分析了重症监护医疗信息市场iii数据库中外科重症监护病人的数据。我们比较了慢性阻塞性肺病患者和非慢性阻塞性肺病患者的AKI发生率、住院死亡率、icu和住院时间（ICU-LOS， HLOS）。在亚组分析中，我们比较了接受心脏（CS）和非心脏手术（NCS）的患者的预后。结果：共分析21720例，其中9.7%为慢性阻塞性肺病。COPD患者比无COPD患者更年轻(64岁（52-75岁）vs.71岁（63-78岁）。结论：COPD对CS-和ncs -患者的预后有不同的影响。在cs患者中，COPD与较高的院内死亡风险相关，而在ncs患者中，COPD与较高的AKI风险、较长的ICU-LOS和HLOS相关。

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

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.