UNASSIGNED: A total of 1096 patients with severe AKI initiating CRRT were identified for inclusion in this retrospective observational study. Patients were divided into three groups according to GNRI tertiles, with tertile 1 as the reference. The outcomes of interest were the 28- and 90-days of all-cause mortality. The associations between GNRI and clinical outcomes were estimated using multivariate Cox proportional hazards model analysis.
UNASSIGNED: The overall mortality rates at 28- and 90-days were 61.6% (675/1096) and 71.5% (784/1096), respectively. After adjusting for multiple confounding factors, GNRI was identified as an independent prognostic factor for 28-days all-cause mortality (HR, 0.582; 95% CI, 0.467-0.727; p < .001 for tertile 3 vs. tertile 1) as well as 90-days all-cause mortality (HR, 0.540; 95% CI, 0.440-0.661; p < .001 for tertile 3 vs. tertile 1). The observed inverse associations were robust across subgroup analysis, and were more pronounced in elderly patients over 65 years of age. Finally, incorporating GNRI in a model with established risk factors might significantly improve its predictive power for the short-term death.
UNASSIGNED: GNRI is considered to be a useful prognostic factor in patients with severe AKI initiating CRRT, especially in elderly patients.
■共有1096例严重AKI患者开始CRRT被纳入这项回顾性观察研究。根据GNRI三元率将患者分为三组,以1为参考。感兴趣的结果是全因死亡率的28天和90天。使用多变量Cox比例风险模型分析估计GNRI与临床结果之间的关联。
■28天和90天的总死亡率分别为61.6%(675/1096)和71.5%(784/1096),分别。在调整了多个混杂因素后,GNRI被确定为28天全因死亡率的独立预后因素(HR,0.582;95%CI,0.467-0.727;三分位数3与三元1)以及90天全因死亡率(HR,0.540;95%CI,0.440-0.661;三分位数3与p<.001Tertile1)。观察到的逆关联在亚组分析中是稳健的,在65岁以上的老年患者中更为明显。最后,将GNRI纳入具有既定风险因素的模型中,可能会显著提高其对短期死亡的预测能力.
■GNRI被认为是严重AKI患者开始CRRT的有用预后因素,尤其是老年患者。