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宋训君.脓毒性急性肾损伤患者死亡预测模型的建立[J].内科急危重症杂志,2025,31(4):348-350
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| DOI：10.11768/nkjwzzzz20250412 |
| 中文关键词: 脓毒性急性肾损伤 器官衰竭数目 死亡 影响 |
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| 摘要点击次数: 10 |
| 全文下载次数: 11 |
| 中文摘要: |
| 摘要 目的：建立脓毒性急性肾损伤（S-AKI）患者死亡的预测模型并验证其效能。方法：采用回顾性研究方法。选取S-AKI患者129例，根据30d转归，分为存活组37例和死亡组92例，比较2组的一般临床资料，建立S-AKI患者死亡的Cox比例风险回归预测模型，并进行验证。结果：随着器官衰竭数目的增加，患者急性生理学及慢性健康状况评估Ⅱ（APACHEⅡ）评分及病死率明显增加，器官衰竭数目>4个，死亡率≥80.49%（P<0.05）。年龄、脓毒症病程、APACHEⅡ评分、序贯性器官衰竭评估（SOFA）评分、细菌感染、急性肾损伤分期、器官衰竭数目均是S-AKI患者死亡的独立影响因素，纳入器官衰竭数目的Cox比例风险回归模型对S-AKI患者死亡具有较好预测价值。结论：年龄≥64.9岁、脓毒症病程>3d、APACHEⅡ评分≥25.97分、SOFA评分≥11.23分、细菌感染、AKI（2期、3期）、器官衰竭数目≥3均会增加S-AKI患者死亡风险。 |
| 英文摘要: |
| Abstract Objective: To establish a predictive model for mortality in patients with septic acute kidney injury (S-AKI) and verify its efficacy. Method: A retrospective research method was adopted. A total of 129 patients with S-AKI were selected and divided into a survival group of 37 cases and a death group of 92 cases based on the 30-day outcome. The general clinical data of the two groups were compared, and a Cox proportional hazards regression prediction model for the death of S-AKI patients was established and verified. Results: With the increase in the number of organ failures, the Acute Physiology and Chronic Health Assessment II (APACHET) score and mortality rate of patients increased significantly. When the number of organ failures was greater than 4, the mortality rate was ≥80.49% (P<0.05). Age, duration of sepsis, APACHE II score, Sequential Organ Failure Assessment (SOFA) score, bacterial infection, stage of AKI, and number of organ failures were all independent influencing factors for the death of patients with S-AKI. The Cox proportional hazards regression model including the number of organ failures had a good predictive value for the death of patients with S-AKI. Conclusion: Age ≥64.9 years old, sepsis course >3 days, APACHEI score ≥25.97 points, SOFA score ≥11.23 points, bacterial infection, AKI (stage 2, stage 3), and the number of organ failures >3 all increase the risk of death in patients with S-AKI. |
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