JAHA:心脏手术后急性肾损伤的更好预测指标

2020-07-29 xiangting MedSci原创

这些数据表明,高AUC是体外循环后AKI的重要独立危险因素,可以考虑将其作为AKI的风险预测模型。

这项研究目的是比较氧输送(DO2)阈值下的曲线下最大面积(AUC)与DO2阈值下累积AUC预测体外循环心脏手术后急性肾损伤(AKI)的准确性。

2017年3月至2019年10月,纳入202例接受体外循环心脏手术的患者。每20秒记录一次灌注参数,DO2(10×泵流量指数[L/min/m2]×[血红蛋白(g/dL)×1.36×动脉血氧饱和度(%)+动脉血氧分压(mmHg)×0.003])阈值为300mL/min/m2被定义为DO2充足。使用DO2最低值、曲线下累积AUC和曲线下最大AUC 来预测AKI发生率。

在12.4%的患者中观察到了术后AKI(25/202)。通过多因素分析,发现最大AUC≥880(比值比[OR],4.9; 95%CI,1.2–21.5[P=0.022])、术前血红蛋白浓度≤11.6g/dL(OR,7.6;95%CI,2.0–32.3[P=0.004])、体外循环时输注红细胞≥2U(OR,3.3;95%CI,1.0-11.1 [P=0.041])是AKI的独立危险因素。受试者工作曲线分析显示,与DO2最低值和累积AUC(面积间差异为0.0691 [P=0.006]和0.0395[P=0.001])相比,最大AUC能够更准确地预测术后AKI。

这些数据表明,高AUC是体外循环后AKI的重要独立危险因素,可以考虑将其作为AKI的风险预测模型。

原始出处:

Tomoya Oshita. A Better Predictor of Acute Kidney Injury After Cardiac Surgery: The Largest Area Under the Curve Below the Oxygen Delivery Threshold During Cardiopulmonary Bypass. JAHA. July 2020.

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    2021-03-19 ms5233340938792882

    有趣

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=949634, encodeId=8b3594963449, content=有趣, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/AFEE88F419F5C2EE00A4D2529684DE09/100, createdBy=94611950576, createdName=ms5233340938792882, createdTime=Fri Mar 19 23:50:36 CST 2021, time=2021-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=908070, encodeId=98759080e002, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Tue Dec 15 08:44:10 CST 2020, time=2020-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897101, encodeId=b86a89e1014d, content=<a href='/topic/show?id=079682559a1' target=_blank style='color:#2F92EE;'>#肾损伤#</a><a href='/topic/show?id=7cd15239687' target=_blank style='color:#2F92EE;'>#急性肾损伤#</a>,引发因素很多,如<a href='/topic/show?id=f590949e423' target=_blank style='color:#2F92EE;'>#造影剂#</a>是目前多见的一种形式, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82559, encryptionId=079682559a1, topicName=肾损伤), TopicDto(id=52396, encryptionId=7cd15239687, topicName=急性肾损伤), TopicDto(id=94974, encryptionId=f590949e423, topicName=造影剂)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Nov 05 13:57:18 CST 2020, time=2020-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268302, encodeId=d6ed126830263, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Jul 31 02:44:48 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398020, encodeId=2c37139802083, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Fri Jul 31 02:44:48 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407045, encodeId=aa61140e045c2, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Fri Jul 31 02:44:48 CST 2020, time=2020-07-31, status=1, ipAttribution=)]
    2020-12-15 14818eb4m67暂无昵称

    学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=949634, encodeId=8b3594963449, content=有趣, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/AFEE88F419F5C2EE00A4D2529684DE09/100, createdBy=94611950576, createdName=ms5233340938792882, createdTime=Fri Mar 19 23:50:36 CST 2021, time=2021-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=908070, encodeId=98759080e002, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Tue Dec 15 08:44:10 CST 2020, time=2020-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=897101, encodeId=b86a89e1014d, content=<a href='/topic/show?id=079682559a1' target=_blank style='color:#2F92EE;'>#肾损伤#</a><a href='/topic/show?id=7cd15239687' target=_blank style='color:#2F92EE;'>#急性肾损伤#</a>,引发因素很多,如<a href='/topic/show?id=f590949e423' target=_blank style='color:#2F92EE;'>#造影剂#</a>是目前多见的一种形式, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82559, encryptionId=079682559a1, topicName=肾损伤), TopicDto(id=52396, encryptionId=7cd15239687, topicName=急性肾损伤), TopicDto(id=94974, encryptionId=f590949e423, topicName=造影剂)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Nov 05 13:57:18 CST 2020, time=2020-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268302, encodeId=d6ed126830263, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Jul 31 02:44:48 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398020, encodeId=2c37139802083, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Fri Jul 31 02:44:48 CST 2020, time=2020-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407045, encodeId=aa61140e045c2, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Fri Jul 31 02:44:48 CST 2020, time=2020-07-31, status=1, ipAttribution=)]
    2020-11-05 lovetcm

    #肾损伤##急性肾损伤#,引发因素很多,如#造影剂#是目前多见的一种形式

    0

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    2020-07-31 zhaohui6731
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