脑卒中后急性肾损伤发生率及其与患者30天死亡率的关系

Esculapio Pub Date : 2023-08-19 DOI:10.51273/esc23.2519216
Amber Shahzadi, Saima Ambreen, Aimen Malik, Mubariz Ahmed, Sidra Jahangir, Basil Usman
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摘要

目的:探讨脑卒中患者AKI的发生率及其与脑卒中患者30天死亡率的关系。方法:本描述性研究于2020年6月至2021年1月在圣家医院第一医疗单元进行。在获得受试者的知情同意后,采用连续(非概率)抽样将130例ct确诊的卒中(缺血性和出血性)患者纳入研究,这些患者的症状从1-24小时不等。卒中复发史、卒中前肾功能不全患者(尿素>52mg/dl和肌酐;1.2mg/dl, eGFR <90 ml/min,蛋白尿,或根据医疗记录进行透析的患者),未控制的高血压(血压≥180/110 mmHg),酒精使用,静脉药物滥用和糖尿病(BSR >200 mg/dl)被排除在研究之外。记录患者的基线血清肌酐水平,并在72小时后再次记录。一个比;比基线增加0.3 mg/dl被定义为急性肾损伤。死亡率记录在中风后30天内死亡的患者。结果:患者平均年龄55.48±10.85岁。男性81例(62.3%),女性49例(37.7%)。急性肾损伤25例(19.2%)。25例(19.2%)患者(包括有和没有急性肾损伤)在30天内死亡。急性肾损伤与卒中患者30天死亡率之间存在显著相关性(p值<0.001)。这种相关性在所有年龄组、男女中都很显著,无论是否有吸烟史,也无论到达前症状的持续时间(p值<0.001)。结论:脑卒中患者中有一定比例存在急性肾损伤。AKI与中风后30天死亡率之间存在显著关联,表明两者之间可能存在联系。
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Incidence of Acute Kidney Injury after Stroke and Its Association with 30-day Mortality of Stroke Patients
Objective: To investigate the incidence of AKI in stroke patients and its association with 30-day mortality of stroke patients. Method: This descriptive study was conducted in Medical Unit-I, Holy Family Hospital from June 2020 to January 2021. 130 patients with CT-confirmed stroke (both ischemic and hemorrhagic) with symptoms ranging from 1-24 hours were included in the study using consecutive (non-probability) sampling, after informed consent from theattendants. Patients with a history of recurrent stroke, renal dysfunction before stroke (urea > 52mg/dl and creatinine > 1.2mg/dl, eGFR < 90 ml/min, proteinuria, or patients on dialysis as per medical record), uncontrolled hypertension (BP ≥180/110 mmHg), alcohol use, intravenous drug abuse and diabetes (BSR > 200 mg/dl) were excluded from the study. Patients' baseline serum creatinine levels were recorded and were noted again after 72 hours. A > 0.3 mg/dl increase from the baseline was defined as acute kidney injury. Mortality was recorded in patients who died within 30 days of stroke. Results: The mean age of the patients was 55.48 ± 10.85 years. 81 patients (62.3%) were male and 49 (37.7%) were female. 25 (19.2%) patients had acute kidney injury. 25 (19.2%) patients (amongst both with and without acute kidney injury) died within 30 days. There was a significant association between acute kidney injury and 30-day mortality of the stroke patients (p-value<0.001). This association was significant in all age groups, both genders, regardless of present or absent history of smoking and regardless of duration of symptoms prior to arrival (p value <0.001). Conclusion: Acute kidney injury affects a proportion of patients of stroke. There is a significant association between AKI and 30-day mortality after stroke, suggesting there might be a link between them.
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