One-year mortality among Danish intensive care patients with acute kidney injury a cohort study 英文参考文献.docVIP

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One-year mortality among Danish intensive care patients with acute kidney injury a cohort study 英文参考文献.doc

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One-year mortality among Danish intensive care patients with acute kidney injury a cohort study 英文参考文献

Gammelageretal.CriticalCare2012,16:R124 /content/16/4/R124 RESEARCH OpenAccess One-yearmortalityamongDanishintensivecare patientswithacutekidneyinjury:acohortstudy HenrikGammelager1*,ChristianFynboChristiansen1,MartinBergJohansen1,ElseT?nnesen2,BenteJespersen3 andHenrikToftS?rensen1 Abstract Introduction:Therearefewstudiesonlong-termmortalityamongintensivecareunit(ICU)patientswithacute kidneyinjury(AKI).WeassessedtheprevalenceofAKIatICUadmission,itsimpactonmortalityduringoneyearof follow-up,andwhethertheinfluenceofAKIvariedinsubgroupsofICUpatients. Methods:WeidentifiedalladultsadmittedtoanyICUinNorthernDenmark(approximately1.15million inhabitants)from2005through2010usingpopulation-basedmedicalregistries.AKIwasdefinedatICUadmission basedontherisk,injury,failure,lossofkidneyfunction,andend-stagekidneydisease(RIFLE)classification,using plasmacreatininechanges.Weincludedfourseveritylevels:AKI-risk,AKI-injury,AKI-failure,andwithoutAKI.We estimatedcumulativemortalitybytheKaplan-Meiermethodandhazardratios(HRs)usingaCoxmodeladjusted forpotentialconfounders.WecomputedestimatesforallICUpatientsandforsubgroupswithdifferent comorbiditylevels,chronickidneydiseasestatus,surgicalstatus,primaryhospitaldiagnosis,andtreatmentwith mechanicalventilationorwithinotropes/vasopressors. Results:Weidentified30,762ICUpatients,ofwhich4,793(15.6%)hadAKIatICUadmission.Thirty-daymortality was35.5%fortheAKI-riskgroup,44.2%fortheAKI-injurygroup,and41.0%fortheAKI-failuregroup,compared with12.8%forpatientswithoutAKI.ThecorrespondingadjustedHRswere1.96(95%confidenceinterval(CI)1.80- 2.13),2.60(95%CI2.38to2.85)and2.41(95%CI2.21to2.64),comparedtopatientswithoutAKI.Amongpatients surviving30days(n=25,539),31-to365daymortalitywas20.5%fortheAKI-riskgroup,23.8%fortheAKI-injury group,and23.2%fortheAKI-failuregroup,comparedwith10.7%forpatientswithoutAKI,correspondingto adjustedHRsof1.33(95%CI1.17to1.51),1.60(95%CI1.37to1.87),and1.64(95%CI1.42to1.90),respectively. TheassociationbetweenAKIand30-daymortalitywas