全球造影剂短缺期间造影剂配给对发生 AKI 的影响

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
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引用次数: 0

摘要

背景2022 年 4 月,COVID-19 大流行导致全球静脉注射造影剂 (ICM) 短缺,我们的医疗保健系统因此采取了配给措施。研究目的我们试图确定 ICM 使用量的减少是否与急性肾损伤 (AKI) 发病率的变化有关。纳入的成年患者均接受过腹部 CT 检查,并至少在 24 小时内测量过两次血肌酐。将 7 天内获得的最大肌酐值减去初始肌酐值,即可确定肌酐的最大增幅。结果 共有 2168 名患者符合纳入标准(纳入前 1082 人;纳入后 1086 人)。两组患者在年龄、性别、合并症、体质或初始估计肾小球滤过率方面无明显差异。在配药前组,87.7% 的患者接受了 ICM 治疗,而配药后为 42.7%。根据基线肾功能进行分层,并根据年龄、性别、种族、合并症和急诊严重程度指数进行调整后,各组之间的 AKI 发生率无明显差异(11.1% 对 11.0%)。这进一步证实了之前的研究结果,即没有证据表明 ICM 的使用与 AKI 之间存在关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Contrast Rationing on the Development of Acute Kidney Injury During the Global Contrast Shortage

Background

In April of 2022, the COVID-19 pandemic resulted in a global shortage of intravenous contrast media (ICM), which led our health care system to implement rationing measures.

Study Objectives

We set out to determine if the reduction in ICM use was associated with a change in the incidence of acute kidney injury (AKI).

Methods

We conducted a multicenter retrospective cohort analysis to compare the incidence of AKI in patients who presented before and after ICM rationing. Adult patients who had a CT of the abdomen performed who had at least 2 creatinine measurements, at least 24 h apart, were included. The maximum increase in creatinine was determined by subtracting the maximal creatinine obtained within 7 days with the initial creatinine. The primary outcome was the development of AKI.

Results

A total of 2168 patients met inclusion criteria (1082 before; 1086 after). There was no significant difference in age, gender, comorbid conditions, disposition, or initial estimated glomerular filtration rate between groups. In the prerationing group, 87.7% of patients received ICM compared to 42.7% after. There was no significant difference in the development of AKI between groups (11.1% vs. 11.0%), including when stratified by baseline renal function and adjusted for age, sex, race, comorbid conditions, and emergency severity index.

Conclusions

The dramatic reduction in ICM use that resulted from the global shortage was not associated with a change in the incidence of AKI. This reinforces the results of previous studies which have failed to find evidence of a relationship between ICM administration and AKI.

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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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