PDF(Pubmed)
Abstract：
Sepsis-induced acute kidney injury (AKI) is a common complication in patients with severe illness and leads to increased risks of mortality and chronic kidney disease. We investigated the association between monocyte distribution width (MDW), red-blood-cell volume distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), sepsis-related organ-failure assessment (SOFA) score, mean arterial pressure (MAP), and other risk factors and sepsis-induced AKI in patients presenting to the emergency department (ED). This retrospective study, spanning 1 January 2020, to 30 November 2020, was conducted at a university-affiliated teaching hospital. Patients meeting the Sepsis-2 consensus criteria upon presentation to our ED were categorized into sepsis-induced AKI and non-AKI groups. Clinical parameters (i.e., initial SOFA score and MAP) and laboratory markers (i.e., MDW, RDW, and NLR) were measured upon ED admission. A logistic regression model was developed, with sepsis-induced AKI as the dependent variable and laboratory parameters as independent variables. Three multivariable logistic regression models were constructed. In Model 1, MDW, initial SOFA score, and MAP exhibited significant associations with sepsis-induced AKI (area under the curve [AUC]: 0.728, 95% confidence interval [CI]: 0.668-0.789). In Model 2, RDW, initial SOFA score, and MAP were significantly correlated with sepsis-induced AKI (AUC: 0.712, 95% CI: 0.651-0.774). In Model 3, NLR, initial SOFA score, and MAP were significantly correlated with sepsis-induced AKI (AUC: 0.719, 95% CI: 0.658-0.780). Our novel models, integrating MDW, RDW, and NLR with initial SOFA score and MAP, can assist with the identification of sepsis-induced AKI among patients with sepsis presenting to the ED.
摘要：
脓毒症诱导的急性肾损伤（AKI）是重症患者的常见并发症，并导致死亡和慢性肾脏疾病的风险增加。我们调查了单核细胞分布宽度(MDW)与红细胞体积分布宽度（RDW），中性粒细胞与淋巴细胞比率（NLR），脓毒症相关器官衰竭评估（SOFA）评分，平均动脉压(MAP),急诊（ED）患者的其他危险因素和脓毒症诱导的AKI。这项回顾性研究,从2020年1月1日至2020年11月30日，在一所大学附属教学医院进行。在提交给我们的ED后符合脓毒症-2共识标准的患者被分为脓毒症诱导的AKI和非AKI组。临床参数(即，初始SOFA评分和MAP)和实验室标记(即，MDW,RDW,和NLR)在ED入院时测量。建立了逻辑回归模型，以脓毒症诱导的AKI为因变量，实验室参数为自变量。建立了三个多变量logistic回归模型。在模型1中，MDW，初始SOFA分数，和MAP表现出与脓毒症诱导的AKI显著相关(曲线下面积[AUC]:0.728,95%置信区间[CI]:0.668-0.789)。在模型2中，RDW，初始SOFA分数，和MAP与脓毒症诱导的AKI显着相关（AUC：0.712，95％CI：0.651-0.774）。在Model3中，NLR，初始SOFA分数，和MAP与脓毒症诱导的AKI显着相关（AUC：0.719，95％CI：0.658-0.780）。我们新颖的模特，集成MDW，RDW,以及初始SOFA评分和MAP的NLR，可以帮助鉴定败血症患者中败血症引起的AKI。
