Prognostic factors of sepsis complicated with acute kidney injury in elderly patients
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摘要: 目的 探讨老年脓毒症并发急性肾损伤(acute kidney injury，AKI)患者的预后及危险因素。 方法 选取2014年1月-2017年6月本院收治的248例老年脓毒症合并AKI患者，平均年龄(75.36±9.84)岁，根据患者28 d生存情况分为存活组(132例)和死亡组(116例)。应用单因素及多因素Logistic回归分析患者死亡的危险因素。 结果 在248例脓毒症并发AKI患者中死亡116例，病死率高达46.8%(116/248)。248例中腹腔感染38.7%(96/248)，肺部感染31.0%(77/248)。单因素及多因素分析显示，少尿[OR=2.048(95% CI：1.512 ～ 3.096)]、肾外器官衰竭[OR=2.375(95% CI：1.706 ～ 3.518)]、血尿素氮(blood urea nitrogen，BUN)升高 [OR=1.658(95% CI：1.163 ～ 2.705)]、白蛋白 (albumin，Alb)降低 [OR=0.714(95% CI：0.638 ～ 0.852)]是老年脓毒症并发AKI患者死亡的独立危险因素(P< 0.05)。 结论 少尿、肾外器官衰竭、BUN升高、Alb降低是老年脓毒症并发AKI患者预后不良的独立危险因素，应做到早预防、早发现，以降低患者的死亡风险。Abstract: Objective To investigate the prognosis and risk factors of sepsis complicated with acute kidney injury (AKI) in elderly patients. Methods From January 2014 to June 2017, 248 elderly patients admitted to our hospital for sepsis complicated with AKI were enrolled in our study. There were 150 males and 98 females with average age of (75.36±9.84) years. According to the 28 days survival of patients, they were divided into survival group (n=132) and death group (n=116). Univariate and multivariate logistic regression analysis was used to analyze the risk factors of poor prognosis. Results Of the 248 cases, 116 cases died, with the fatality rate of 46.8% (116/248). Intraabdominal infection occurred in 96 cases (38.7%) and lung infection in 77 cases (31%). Univariate and multivariate analysis showed that oliguria[OR, 2.048 (95% CI:1.512-3.096)], extrarenal organ failure[OR, 2.375 (95% CI:1.706-3.518)], elevated blood urea nitrogen (BUN)[OR, 1.658 (95% CI:1.163-2.705)] and decreased albumin (Alb)[OR, 0.714(95% CI:0.638-0.852)] were independent risk factors for death in elderly patients with sepsis complicated with AKI (P< 0.05). Conclusion Oliguria, organ failure, elevated BUN and decreased Alb are independent risk factors for death in elderly patients with sepsis complicated with AKI. Early prevention and early detection should be done to reduce the risk of death.
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Keywords:
- sepsis /
- acute kidney injury /
- aged
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