一项观察性研究:用平均尿量减少与持续尿量减少来定义重症患者的少尿。

IF 8.5 1区 医学 Q1 UROLOGY & NEPHROLOGY Clinical Journal of the American Society of Nephrology Pub Date : 2024-06-07 DOI:10.2215/CJN.0000000000000493
Céline Monard, Nathan Bianchi, Tatiana Kelevina, Marco Altarelli, Aziz Chaouch, Antoine Schneider
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引用次数: 0

摘要

背景:少尿是指尿量(UO)低于方法:我们分析了 2010 年至 2020 年期间入住重症监护室的所有成人,但不包括那些正在进行慢性透析或拒绝同意透析的人。我们提取了每小时的尿量,并根据平均法(平均尿量低于阈值)和持续法(所有测量值均低于阈值)在六个小时的滑动时间窗口内评估是否存在少尿。对于这两种方法,我们比较了少尿的发生率及其与 90 天死亡率和出院时急性肾病(AKD)的关系:在 15,253 名患者中,平均法比持续法更容易发现少尿(73% [95%CI 72.3-73.7] 对 54.3% [53.5-55.1])。在预测 90 天死亡率(85% [83.6-86.4] vs 70.3% [68.5 - 72])和出院时 AKD(85.6% [84.2-87] vs 71.8% [70-73.6])方面,平均法显示出更高的灵敏度。然而,其对这两种结果的特异性较低(29.8% [28.9-30.6] vs 49.4% [48.5-50.3] 和 29.8% [29-30.7] vs 49.8% [48.9-50.7])。在对疾病严重程度、合并症、年龄、入院年份、体重、性别和入院时急性肾损伤(AKI)进行调整后,两种方法在人群水平上的少尿导致的死亡率绝对差异相似(5%)。当分析对象仅限于入院时无急性肾损伤、有体重记录、住院期间留置导尿管、未接受肾脏替代治疗或利尿剂的患者时,也得出了类似的结果:结论:少尿的评估方法对诊断和预后有重要影响。结论:少尿的评估方法对诊断和预后有重要影响,其定义应标准化。
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Averaged versus Persistent Reduction in Urine Output to Define Oliguria in Critically Ill Patients: An Observational Study.
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来源期刊
CiteScore
12.20
自引率
3.10%
发文量
514
审稿时长
3-6 weeks
期刊介绍: The Clinical Journal of the American Society of Nephrology strives to establish itself as the foremost authority in communicating and influencing advances in clinical nephrology by (1) swiftly and effectively disseminating pivotal developments in clinical and translational research in nephrology, encompassing innovations in research methods and care delivery; (2) providing context for these advances in relation to future research directions and patient care; and (3) becoming a key voice on issues with potential implications for the clinical practice of nephrology, particularly within the United States. Original manuscript topics cover a range of areas, including Acid/Base and Electrolyte Disorders, Acute Kidney Injury and ICU Nephrology, Chronic Kidney Disease, Clinical Nephrology, Cystic Kidney Disease, Diabetes and the Kidney, Genetics, Geriatric and Palliative Nephrology, Glomerular and Tubulointerstitial Diseases, Hypertension, Maintenance Dialysis, Mineral Metabolism, Nephrolithiasis, and Transplantation.
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