ICU老年急性肾损伤患者临床特征及死亡率分析  

Clinical features and risk factors for mortality of elderly acute kidney injury in ICU

作　　者：李楠[1] 范松涛[2] 

机构地区：[1]大连医科大学附属第一医院急诊科,辽宁大连116011 [2]大连医科大学附属第一医院眼科,辽宁大连116011

出　　处：《大连医科大学学报》2013年第1期42-45,共4页Journal of Dalian Medical University

基　　金：大连市科技计划项目(2010E15SF170)

摘　　要：目的探讨ICU老年急性肾损伤患者临床特征和影响死亡的风险因素。方法 ICU老年急性肾损伤患者(年龄≥60岁)共78例。根据其最终结果将这些患者分为生存组和死亡组,比较二组临床特点和实验室检查结果。结果 ICU老年急性肾损伤患者总体死亡率为52.6%。死亡组有38例患有2种或以上基础疾病,占死亡人数92.7%,导致老年ICU患者发生急性肾损伤的主要原因是脓毒症/感染,共51例(65.4%)。随多脏器损伤程度增加,患者死亡率增加。死亡组较对照组机械通气例数增加,脓毒症及严重感染比例增加,血清白蛋白水平降低,CRP增高(P<0.01)。结论 ICU老年急性肾损伤患者预后与基础疾病,多脏器功能损伤程度有关。Objective To investigate the clinical features and the risk factors affecting mortality in elderly patients with a- cute kidney injury （AKI） in ICU. Methods A prospective study on the elderly patients with AKI （age≥60 years old） in ICU was carried out. The 78 elderly patients in ICU with AKI were divided into survivor group and death group according their outcomes. Factors including clinical characteristics and laboratory features were compared between these two groups. Results The mortality rate of the elderly patients with AKI was 52.6%. Thirty - eight patients with two or more underlying diseases in death group accounting for 92.7% of deaths. The main causes of the elderly patients with AKI were sepsis/in- fection （65.4%）. The mortality rate increased with the degree of impaired organs. Significant differences were found be- tween the survival group and non - survival group of the elderly patients in underlying disease, the proportion of sepsis and infections, the level of serum albumin and CRP. Conclusion This study found that concomitant disease and multiple organ dysfunction syndrome （MODS） were the independent risk factors for the death elderly patients with AKI.

关 键 词：急性肾损伤 老年 临床特征 多脏器功能不全 

分 类 号：R692[医药卫生—泌尿科学]