背景:血清乳酸脱氢酶与白蛋白比值(LAR)与恶性肿瘤和肺炎的不良预后相关。然而,很少有研究表明LAR与脓毒症患者急性肾损伤(AKI)的发生有关,在这项研究中进行了调查。
方法:我们基于重症监护医学信息集市(MIMIC)-IV数据库进行了一项回顾性队列研究。主要结果是在2天和7天内发生AKI。使用多变量逻辑回归模型来计算优势比,以验证LAR和AKI之间的关联。住院死亡率,RRT使用,和肾功能的恢复,分别。
结果:本研究共纳入4010名参与者。参与者的中位年龄为63.5岁,中位LAR为10.5。调整混杂变量后,LAR四分位数最高的患者在2天和7天内发生AKI的风险高于LAR四分位数最低的患者,比值比为1.37(95%置信区间[CI]:1.23-1.52)和1.95(95%CI:1.72-2.22),分别。LAR(log2)每增加1个单位,2天和7天内AKI的校正几率分别为1.16(95%CI:1.12-1.20)和1.29(95%CI:1.24-1.35),分别。
结论:本研究表明,脓毒症患者LAR升高与预后不良相关。AKI的风险和住院死亡率增加,对RRT的需求增加,肾功能恢复的机会随着LAR的增加而减少。
BACKGROUND: Serum lactate dehydrogenase to albumin ratio (LAR) is associated with poor outcomes in malignancy and pneumonia. However, there are few studies suggesting that LAR is associated with the occurrence of acute kidney injury (AKI) in patients with sepsis, which was investigated in this
study.
METHODS: We conducted a retrospective cohort
study based on the Medical Information Mart for Intensive Care (MIMIC)-IV database. The primary outcome was the occurrence of AKI within 2 days and 7 days. Multivariable logistic regression models were used to calculate odds ratios to validate the association between LAR and AKI, in-hospital mortality, RRT use, and recovery of renal function, respectively.
RESULTS: A total of 4010 participants were included in this
study. The median age of the participants was 63.5 years and the median
LAR was 10.5. After adjusting for confounding variables, patients in the highest LAR quartile had a higher risk of AKI than those in the lowest LAR quartile within 2 days and 7 days, with odds ratios of 1.37 (95% confidence interval [CI]: 1.23-1.52) and 1.95 (95% CI: 1.72-2.22), respectively. The adjusted odds of AKI within 2 and 7 days were 1.16 (95% CI: 1.12-1.20) and 1.29 (95% CI: 1.24-1.35) for each 1 unit increase in LAR(log2), respectively.
CONCLUSIONS: This
study demonstrated that elevated
LAR was associated with poor prognosis in patients with sepsis. The risk of AKI and in-hospital mortality increased, the need for RRT increased, and the chance of recovery of renal function decreased with the increase of LAR.