造影剂对脓毒症急性肾损伤患者长期肾功能和预后的影响：倾向匹配队列研究。

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2024-08-20 DOI:10.1016/j.jcrc.2024.154898

Jinnam Kim , Se Ju Lee , Jung Ho Kim , Jin Young Ahn , Su Jin Jeong , Jun Yong Choi , Joon-Sup Yeom , Hyung Jung Oh , Yong Eun Chung , Nam Su Ku

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引用次数: 0

摘要

目的：研究脓毒性急性肾损伤（AKI）患者使用造影剂与长期死亡率和肾功能之间的关系：我们进行了一项回顾性倾向匹配队列研究，涉及 1521 名因脓毒性休克入院的成年患者。脓毒性急性肾损伤患者均接受了造影剂或非造影剂 CT 扫描。主要结果是 90 天死亡率和 90 天内透析率。次要结果包括 AKI 恶化、院内死亡率和 90 天后的透析维持率：研究期间共发现了 609 名脓毒性 AKI 患者，其中 220 人（36.1%）接受了造影剂 CT 检查，389 人（63.9%）接受了非造影剂 CT 检查。经过倾向评分匹配后，得到了 133 对患者。造影剂 CT 组和非造影剂 CT 组在 90 天死亡率（54.9% 对 58.6%，P = 0.579）、90 天内透析率（6.8% 对 8.3%，P = 0.655）、AKI 恶化（2.3% vs. 3.0%，P = 0.706）、院内死亡率（10.6% vs. 14.4%，P = 0.369）或 90 天后维持透析（0.0% vs. 0.8%，P > 0.99）：结论：静脉注射造影剂与脓毒症急性肾脏损伤患者的长期死亡率、肾功能恶化或透析无关。

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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Influence of contrast medium on long-term renal function and outcomes in patients with septic acute kidney injury: A propensity-matched cohort study

Purpose

To investigate the relationship between contrast medium administration and long-term mortality and renal function in patients with septic acute kidney injury (AKI).

Materials and methods

We performed a retrospective, propensity-matched cohort study involving 1521 adult patients admitted with septic shock. Patients with septic AKI who underwent contrast or non-contrast CT scans were enrolled. The primary outcomes were the rates of 90-day mortality and dialysis within 90 days. The secondary outcomes included worsening of AKI, in-hospital mortality, and maintenance of dialysis after 90 days.

Results

During the study period, 609 patients with septic AKI were identified; 220 (36.1%) underwent contrast CT and 389 (63.9%) underwent non-contrast CT. After propensity score matching, 133 pairs were obtained. There were no significant differences between the contrast and non-contrast CT groups in 90-day mortality (54.9% vs. 58.6%, P = 0.579), dialysis within 90 days (6.8% vs. 8.3%, P = 0.655), worsening AKI (2.3% vs. 3.0%, P = 0.706), in-hospital mortality (10.6% vs. 14.4%, P = 0.369), or maintenance of dialysis after 90 days (0.0% vs. 0.8%, P > 0.99).

Conclusions

The administration of intravenous contrast medium was not associated with long-term mortality, deterioration of renal function, or dialysis in patients with septic AKI.

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.