Sameer Arora, Arpit Agrawal, Venugopalan Y Vishnu, Mamta B Singh, Vinay Goyal, Padma M V Srivastava
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Secondary outcome measures were all-cause mortality, duration of hospital stay, need for dialysis, and comparison of outcomes in ischemic and hemorrhagic stroke. For both the stroke subtypes, we employed a multivariate logistic regression model, with AKI and hospital mortality being the outcomes. Covariates included gender, age, ventilatory requirement, duration of hospital stay, and National Institutes of Health Stroke Scale score at admission.</p><p><strong>Results: </strong>There were 144 cases of ischemic stroke with 12 deaths (8.3%) and 60 cases of intracranial hemorrhage (ICH) with 22 deaths (36.7%). The mean age was 55 years, 72.6% were males, and AKI complicated 34% of ischemic stroke and 66.7% of ICH hospitalizations. AKI was linked to increased hospital mortality from ischemic stroke (odds ratio [OR] 27.21, 95% CI 3.39-218.13) and hemorrhagic stroke (OR 5.12, 95% CI 1.29-20.28) in multivariate analysis stratified by stroke type.</p><p><strong>Conclusions: </strong>AKI complicates stroke frequently and increases hospital mortality. 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引用次数: 0
摘要
背景:急性肾损伤(AKI)在急性卒中患者中很常见。虽然 AKI 与不良临床预后有关,但有关其发病率及其对中风预后影响的数据却很有限:这是一项前瞻性观察研究,在一家三级医疗中心进行,分析了 204 名急性缺血性卒中和脑出血患者的数据。以入院时的血清肌酐为基线,住院 7 天内血清肌酐值在 48 小时内上升 0.3 mg/dl,或比基线上升至少 50%,即定义为 AKI。主要结果是测量急性脑卒中患者中 AKI 的发生率。次要结果指标包括全因死亡率、住院时间、透析需求以及缺血性和出血性中风的结果比较。对于两种中风亚型,我们都采用了多变量逻辑回归模型,以 AKI 和住院死亡率为结果。协变量包括性别、年龄、呼吸机需求、住院时间和入院时美国国立卫生研究院卒中量表评分:结果:144 例缺血性中风患者中有 12 例死亡(8.3%),60 例颅内出血(ICH)患者中有 22 例死亡(36.7%)。平均年龄为 55 岁,72.6% 为男性,34% 的缺血性中风和 66.7% 的 ICH 住院病例合并有 AKI。在按卒中类型分层的多变量分析中,AKI 与缺血性卒中住院死亡率(几率比 [OR] 27.21,95% CI 3.39-218.13)和出血性卒中住院死亡率(OR 5.12,95% CI 1.29-20.28)的增加有关:结论:AKI 常常并发中风并增加住院死亡率。结论:AKI 常常并发中风并增加住院死亡率,需要更多的研究来评估两者之间是否存在因果关系,以及预防 AKI 的措施是否会降低死亡率。
Navigating the Nexus: Acute Kidney Injury in Acute Stroke - A Prospective Cohort Study.
Background: Acute kidney injury (AKI) is prevalent in patients with acute stroke. Although AKI is linked to poor clinical outcomes, data about its incidence and effect on stroke outcomes is limited.
Methods: This was a prospective observational study carried out at a single tertiary care center that analyzed the data of 204 consecutive subjects with acute ischemic stroke and intracerebral hemorrhage. Considering serum creatinine at admission as the baseline, AKI was defined as a rise in serum creatinine value of 0.3 mg/dl over 48 h or a percentage increase of at least 50% from baseline over 7 days during hospitalization. The primary outcome was to measure the prevalence of AKI in patients with acute stroke. Secondary outcome measures were all-cause mortality, duration of hospital stay, need for dialysis, and comparison of outcomes in ischemic and hemorrhagic stroke. For both the stroke subtypes, we employed a multivariate logistic regression model, with AKI and hospital mortality being the outcomes. Covariates included gender, age, ventilatory requirement, duration of hospital stay, and National Institutes of Health Stroke Scale score at admission.
Results: There were 144 cases of ischemic stroke with 12 deaths (8.3%) and 60 cases of intracranial hemorrhage (ICH) with 22 deaths (36.7%). The mean age was 55 years, 72.6% were males, and AKI complicated 34% of ischemic stroke and 66.7% of ICH hospitalizations. AKI was linked to increased hospital mortality from ischemic stroke (odds ratio [OR] 27.21, 95% CI 3.39-218.13) and hemorrhagic stroke (OR 5.12, 95% CI 1.29-20.28) in multivariate analysis stratified by stroke type.
Conclusions: AKI complicates stroke frequently and increases hospital mortality. Additional studies are required to assess if the association is causal and if remedies to prevent AKI would decrease mortality.
期刊介绍:
The journal has a clinical foundation and has been utilized most by clinical neurologists for improving the practice of neurology. While the focus is on neurology in India, the journal publishes manuscripts of high value from all parts of the world. Journal publishes reviews of various types, original articles, short communications, interesting images and case reports. The journal respects the scientific submission of its authors and believes in following an expeditious double-blind peer review process and endeavors to complete the review process within scheduled time frame. A significant effort from the author and the journal perhaps enables to strike an equilibrium to meet the professional expectations of the peers in the world of scientific publication. AIAN believes in safeguarding the privacy rights of human subjects. In order to comply with it, the journal instructs all authors when uploading the manuscript to also add the ethical clearance (human/animals)/ informed consent of subject in the manuscript. This applies to the study/case report that involves animal/human subjects/human specimens e.g. extracted tooth part/soft tissue for biopsy/in vitro analysis.