Abstract：
UNASSIGNED: Whether advanced age is associated with poor outcomes of elderly patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) is controversial. This study aimed to evaluate age effect and predictors for mortality in elderly AKI patients undergoing CRRT.
UNASSIGNED: Data of 480 elderly AKI patients who underwent CRRT were retrospectively analyzed. Subjects were stratified into two groups according to age: younger-old (age, 65-74 years; n = 205) and older-old (age, ≥75 years; n = 275). Predictors for 28-day and 90-day mortality and age effects were analyzed using multivariable Cox regression analysis and propensity score matching.
UNASSIGNED: Urine output at the start of CRRT (adjusted hazard ratio [aHR], 0.99; 95% confidence interval [CI], 0.99-1.00; p = 0.04), operation (aHR, 0.53; 95% CI, 0.30-0.93; p = 0.03), and use of an intra-aortic balloon pump (aHR, 3.60; 95% CI, 1.18-10.96; p = 0.02) were predictors for 28-day mortality. Ischemic heart disease (aHR, 1.74; 95% CI, 1.02-2.98; p = 0.04) and use of a ventilator (aHR, 0.56; 95% CI, 0.36-0.89; p = 0.01) were predictors for 90-day mortality. The older-old group did not exhibit a higher risk for 28-day or 90-day mortality than the younger-old group in multivariable or propensity score-matched models.
UNASSIGNED: Advanced age was not a risk factor for mortality among elderly AKI patients undergoing CRRT, suggesting that advanced age should not be considered for therapeutic decisions in critically ill elderly patients with AKI requiring CRRT.
UNASSIGNED: Data of 480 elderly AKI patients who underwent CRRT were retrospectively analyzed. Subjects were stratified into two groups according to age: younger-old (age, 65-74 years; n = 205) and older-old (age, ≥75 years; n = 275). Predictors for 28-day and 90-day mortality and age effects were analyzed using multivariable Cox regression analysis and propensity score matching.
UNASSIGNED: Urine output at the start of CRRT (adjusted hazard ratio [aHR], 0.99; 95% confidence interval [CI], 0.99-1.00; p = 0.04), operation (aHR, 0.53; 95% CI, 0.30-0.93; p = 0.03), and use of an intra-aortic balloon pump (aHR, 3.60; 95% CI, 1.18-10.96; p = 0.02) were predictors for 28-day mortality. Ischemic heart disease (aHR, 1.74; 95% CI, 1.02-2.98; p = 0.04) and use of a ventilator (aHR, 0.56; 95% CI, 0.36-0.89; p = 0.01) were predictors for 90-day mortality. The older-old group did not exhibit a higher risk for 28-day or 90-day mortality than the younger-old group in multivariable or propensity score-matched models.
UNASSIGNED: Advanced age was not a risk factor for mortality among elderly AKI patients undergoing CRRT, suggesting that advanced age should not be considered for therapeutic decisions in critically ill elderly patients with AKI requiring CRRT.
摘要：
■老年急性肾损伤(AKI)患者需要持续肾脏替代治疗(CRRT)时，高龄是否与不良预后相关仍存在争议。本研究旨在评估接受CRRT的老年AKI患者的年龄效应和死亡率预测因素。对
■480例接受CRRT的老年AKI患者资料进行回顾性分析。根据年龄将受试者分为两组：年龄较小（年龄，65-74岁；n=205)和老年人(年龄，≥75岁；n=275)。使用多变量Cox回归分析和倾向评分匹配分析了28天和90天死亡率和年龄影响的预测因子。
■CRRT开始时的尿液输出（调整后的危险比[aHR]，0.99；95%置信区间[CI]，0.99-1.00；p=0.04），操作(AHR，0.53；95%CI，0.30-0.93；p=0.03），和使用主动脉内球囊泵(aHR，3.60；95%CI，1.18-10.96；p=0.02）是28天死亡率的预测因子。缺血性心脏病（aHR，1.74；95%CI，1.02-2.98；p=0.04）和呼吸机的使用（aHR，0.56；95%CI，0.36-0.89；p=0.01）是90天死亡率的预测因子。在多变量或倾向得分匹配的模型中，老年组的28天或90天死亡率未表现出比年轻组更高的风险。
■高龄不是接受CRRT的老年AKI患者死亡的危险因素，提示在需要CRRT的AKI危重老年患者的治疗决策中不应考虑高龄.
■480例接受CRRT的老年AKI患者资料进行回顾性分析。根据年龄将受试者分为两组：年龄较小（年龄，65-74岁；n=205)和老年人(年龄，≥75岁；n=275)。使用多变量Cox回归分析和倾向评分匹配分析了28天和90天死亡率和年龄影响的预测因子。
■CRRT开始时的尿液输出（调整后的危险比[aHR]，0.99；95%置信区间[CI]，0.99-1.00；p=0.04），操作(AHR，0.53；95%CI，0.30-0.93；p=0.03），和使用主动脉内球囊泵(aHR，3.60；95%CI，1.18-10.96；p=0.02）是28天死亡率的预测因子。缺血性心脏病（aHR，1.74；95%CI，1.02-2.98；p=0.04）和呼吸机的使用（aHR，0.56；95%CI，0.36-0.89；p=0.01）是90天死亡率的预测因子。在多变量或倾向得分匹配的模型中，老年组的28天或90天死亡率未表现出比年轻组更高的风险。
■高龄不是接受CRRT的老年AKI患者死亡的危险因素，提示在需要CRRT的AKI危重老年患者的治疗决策中不应考虑高龄.
