Acute kidney injury-attributable mortality in critically ill patients with sepsis

PeerJ

article

Zhiyi Wang¹  Jie Weng¹  Jinwen Yang³  Xiaoming Zhou¹  Zhe Xu⁴  Ruonan Hou¹  Zhiliang Zhou¹  Liang Wang⁵  Chan Chen³  Shengwei Jin⁶ 

[1] Department of General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University;Center for Health Assessment, Wenzhou Medical University;Department of Geriatric Medicine, The First Affiliated Hospital, Wenzhou Medical University;Department of Emergency Intensive Care Unit, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University;Department of Public Health, Robbins College of health and Human Sciences, Baylor University;Department of Anesthesia and Critical Care, the Second Affiliated Hospital of Wenzhou Medical University

关键词: Acute kidney injury;    Attributable mortality;    Sepsis;    Mortality;   

DOI  :  10.7717/peerj.13184

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundTo assess whether acute kidney injury (AKI) is independently associated with hospital mortality in ICU patients with sepsis, and estimate the excess AKI-related mortality attributable to AKI.MethodsWe analyzed adult patients from two distinct retrospective critically ill cohorts: (1) Medical Information Mart for Intensive Care IV (MIMIC IV; n = 15,610) cohort and (2) Wenzhou (n = 1,341) cohort. AKI was defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We applied multivariate logistic and linear regression models to assess the hospital and ICU mortality, hospital length-of-stay (LOS), and ICU LOS. The excess attributable mortality for AKI in ICU patients with sepsis was further evaluated.ResultsAKI occurred in 5,225 subjects in the MIMIC IV cohort (33.5%) and 494 in the Wenzhou cohort (36.8%). Each stage of AKI was an independent risk factor for hospital mortality in multivariate logistic regression after adjusting for baseline illness severity. The excess attributable mortality for AKI was 58.6% (95% CI [46.8%–70.3%]) in MIMIC IV and 44.6% (95% CI [12.7%–76.4%]) in Wenzhou. Additionally, AKI was independently associated with increased ICU mortality, hospital LOS, and ICU LOS.ConclusionAcute kidney injury is an independent risk factor for hospital and ICU mortality, as well as hospital and ICU LOS in critically ill patients with sepsis. Thus, AKI is associated with excess attributable mortality.

【 授权许可】

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