COVID-19 住院患者估计血浆容量与新发急性肾损伤的关系

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

American Journal of the Medical Sciences Pub Date : 2024-07-14 DOI:10.1016/j.amjms.2024.07.018

Shahin Isha MBBS, MD , Prasanth Balasubramanian MBBS, MD , Lekhya Raavi MBBS, MD , Abby J. Hanson BS , Anna Jenkins BS , Parthkumar Satashia MBBS, MD , Arvind Balavenkataraman MBBS, MD , Iván A. Huespe MD , Aysun Tekin MD , Vikas Bansal MBBS, MPH , Sean M. Caples DO, MS , Syed Anjum Khan MD , Nitesh K. Jain MBBS , Abigail T. LaNou MD , Rahul Kashyap MBBS, MBA , Rodrigo Cartin-Ceba MD , Bhavesh M. Patel MD , Houssam Farres MD , Scott A. Helgeson MD , Ricardo Diaz Milian MD , Devang K. Sanghavi MBBS, MD

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引用次数: 0

摘要

目的：探讨作为血容量状态替代指标的估计血浆容量（ePV）和血浆容量状态（PVS）与 COVID-19 住院患者新发 AKI 和住院死亡率的关系：我们对梅奥诊所企业医疗系统收治的 COVID-19 相关 ARDS 患者进行了一项多中心回顾性研究。使用 ePV 和 PVS 的公式计算血浆容量，并进行纵向分析，以发现 ePV 和 PVS 与作为主要结果的住院期间新发 AKI 和作为次要结果的院内死亡率之间的关系：我们的分析纳入了 7616 例 COVID-19 患者，其中 1365 例（17.9%）发生了新发 AKI，死亡率为 25.96%。纵向多层次多变量分析显示，ePV（OR 1.162；95% CI 1.048-1.288，p=0.004）和 PVS（OR 1.032；95% CI 1.012-1.050，p=0.001）是新发 AKI 的独立预测因子。较高的PVS与较高的院内死亡率（OR 1.038，95% CI 1.007-1.070，p=0.017）独立相关，但与ePV（OR 0.868，95% CI 0.740-1.018，p=0.082）无关：结论：在我们的 COVID-19 住院患者队列中，较高的 PVS 与较高的新发 AKI 发生率和较差的预后相关。需要进一步开展大规模前瞻性研究，以了解其效用。

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Association of estimated plasma volume with new onset acute kidney injury in hospitalized COVID-19 patients

Purpose

To explore the association of estimated plasma volume (ePV) and plasma volume status (PVS) as surrogates of volume status with new-onset AKI and in-hospital mortality among hospitalized COVID-19 patients.

Materials and methods

We performed a retrospective multi-center study on COVID-19-related ARDS patients who were admitted to the Mayo Clinic Enterprise health system. Plasma volume was calculated using the formulae for ePV and PVS, and longitudinal analysis was performed to find the association of ePV and PVS with new-onset AKI during hospitalization as the primary outcome and in-hospital mortality as a secondary outcome.

Results

Our analysis included 7616 COVID-19 patients with new-onset AKI occurring in 1365 (17.9%) and a mortality rate of 25.96% among them. A longitudinal multilevel multivariate analysis showed both ePV (OR 1.162; 95% CI 1.048–1.288, p=0.004) and PVS (OR 1.032; 95% CI 1.012–1.050, p=0.001) were independent predictors of new onset AKI. Higher PVS was independently associated with increased in-hospital mortality (OR 1.038, 95% CI 1.007–1.070, p=0.017), but not ePV (OR 0.868, 95% CI 0.740–1.018, p=0.082).

Conclusion

A higher PVS correlated with a higher incidence of new-onset AKI and worse outcomes in our cohort of hospitalized COVID-19 patients. Further large-scale and prospective studies are needed to understand its utility.

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来源期刊

American Journal of the Medical Sciences 医学-医学：内科

CiteScore

4.40

自引率

0.00%

发文量

303

审稿时长

1.5 months

期刊介绍： The American Journal of The Medical Sciences (AJMS), founded in 1820, is the 2nd oldest medical journal in the United States. The AJMS is the official journal of the Southern Society for Clinical Investigation (SSCI). The SSCI is dedicated to the advancement of medical research and the exchange of knowledge, information and ideas. Its members are committed to mentoring future generations of medical investigators and promoting careers in academic medicine. The AJMS publishes, on a monthly basis, peer-reviewed articles in the field of internal medicine and its subspecialties, which include: Original clinical and basic science investigations Review articles Online Images in the Medical Sciences Special Features Include: Patient-Centered Focused Reviews History of Medicine The Science of Medical Education.