Yeji Lee, Taeil Kim, Dong Eon Kim, Eun Mi Jo, Da Woon Kim, Hyo Jin Kim, Eun Young Seong, Sang Heon Song, Harin Rhee
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The contribution of AKI to the in-hospital mortality rate was assessed using a Cox proportional hazards model.</p><p><strong>Results: </strong>A total of 7,150 patients were included in this study. AKI was more frequent in medical (48.7%) than in surgical patients (19.7%), with the severity of AKI higher in medical patients. In surgical patients, hospital-acquired AKI was more frequent (51.0% vs. 49.0%), whereas community-acquired AKI was more common in medical patients (58.5% vs. 41.5%). 16.9% and 5.9% of medical and surgical patients died in the hospital, respectively. AKI affected patient groups to different degrees. In surgical patients, AKI patients had 4.778 folds higher risk of mortality (95% confidence interval [CI], 3.577-6.382; p < 0.001) than non-AKI patients; whereas in medical AKI patients, it was 1.239 (95% CI, 1.051-1.461; p = 0.01).</p><p><strong>Conclusion: </strong>While the prevalence of AKI itself is higher in medical patients, the impact of AKI on mortality was stronger in surgical patients compared to medical patients. 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引用次数: 0
摘要
背景：虽然急性肾损伤（AKI）是危重病人的一种常见并发症，但有关内科和外科重症监护病房（ICU）急性肾损伤患者的流行病学差异和临床特征的知识仍然有限：方法：回顾性分析了 2011 年 1 月至 2020 年 12 月期间釜山大学医院和釜山大学阳山医院重症监护室患者的电子病历。分析了不同患者 AKI 的不同特征。采用 Cox 比例危险模型评估了 AKI 对院内死亡率的影响：本研究共纳入 7150 名患者。内科患者（48.7%）的 AKI 发生率高于外科患者（28.1%），内科患者的 AKI 严重程度更高。在外科患者中，医院获得性 AKI 更为常见（51% 对 49%），而内科患者中社区获得性 AKI 更为常见（58.5% 对 41.5%）。分别有 16.9% 和 5.9% 的内科和外科患者死于医院。AKI 对各组患者的影响程度不同。在手术患者中，AKI 患者的死亡风险比非 AKI 患者高 4.778 倍（3.577, 6.382, p < 0.001），而内科 AKI 患者的死亡风险为 1.239 倍（1.051, 1.461, p = 0.011）：虽然内科患者的 AKI 患病率较高，但与内科患者相比，外科患者的 AKI 对死亡率的影响更大。这表明，需要更加关注围手术期患者，以预防和控制 AKI。
Differences in the incidence, characteristics, and outcomes of patients with acute kidney injury in the medical and surgical intensive care units.
Background: Though acute kidney injury (AKI) is a prevalent complication in critically ill patients, knowledge on the epidemiological differences and clinical characteristics of patients with AKI admitted to medical and surgical intensive care units (ICUs) remains limited.
Methods: Electronic medical records of patients in ICUs in Pusan National University Hospital and Pusan National University Hospital Yangsan, from January 2011 to December 2020, were retrospectively analyzed. Different characteristics of AKI between patients were analyzed. The contribution of AKI to the in-hospital mortality rate was assessed using a Cox proportional hazards model.
Results: A total of 7,150 patients were included in this study. AKI was more frequent in medical (48.7%) than in surgical patients (19.7%), with the severity of AKI higher in medical patients. In surgical patients, hospital-acquired AKI was more frequent (51.0% vs. 49.0%), whereas community-acquired AKI was more common in medical patients (58.5% vs. 41.5%). 16.9% and 5.9% of medical and surgical patients died in the hospital, respectively. AKI affected patient groups to different degrees. In surgical patients, AKI patients had 4.778 folds higher risk of mortality (95% confidence interval [CI], 3.577-6.382; p < 0.001) than non-AKI patients; whereas in medical AKI patients, it was 1.239 (95% CI, 1.051-1.461; p = 0.01).
Conclusion: While the prevalence of AKI itself is higher in medical patients, the impact of AKI on mortality was stronger in surgical patients compared to medical patients. This suggests that more attention is needed for perioperative patients to prevent and manage AKI.
期刊介绍：
Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.
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