内蒙古两家医院住院人群急性肾损伤的临床危害研究  

Clinical hazards of acute kidney injury in hospitalized population in Inner Mongolia Autonomous Region

作　　者：徐丽斌 王亚杰 韩云彪 赵奕雯 朱立革 刘国平 王丹 于磊 Xu Li-bin;Wang Ya-jie;Han Yun-biao;Zhao Yi-wen;Zhu Li-ge;Liu Guo-ping;WangDan;Yu Lei(Baotou Medical College,Baotou 014000,China;Department of Nephrology,Inner Mongolia Autono-mous Region People's Hospital,Hohhot 010020,China;Infirmary of Inner Mongolia Trade Vocational College,Hohhot 010020,China)

机构地区：[1]包头医学院,包头014000 [2]内蒙古自治区人民医院肾内科,呼和浩特010020 [3]内蒙古商贸职业学院医务室,呼和浩特010020

出　　处：《临床肾脏病杂志》2022年第12期987-992,共6页Journal Of Clinical Nephrology

基　　金：内蒙古自治区自然科学基金资助项目(2018LH08001)。

摘　　要：目的探讨内蒙古两家医院急性肾损伤(acute kidney injury,AKI)的临床危害。方法回顾性分析内蒙古自治区人民医院2012年1月1日至2016年12月30日和呼和浩特市第一医院2012年3月1日至2016年12月30日的所有住院患者电子病历,AKI的诊断标准依据改善全球肾脏病预后组织(Kidney Disease Improving Global Outcomes,KDIGO)指南。结果(1)将入组患者按年龄分为<75岁、≥75,<80岁、≥80,<85岁、≥85,<90岁和≥90岁共5个年龄段亚组,病死率分别为1.3%,2.4%、3.3%、4.9%、5.9%;(2)非AKI和AKI患者的住院时间分别为15(11,23)d和17(10,31)d,社区获得性急性肾损伤(community acquired acute kidney injury,CA-AKI)和医院获得性急性肾损伤(hospital acquired acute kidney injury,HA-AKI)的住院时间分别为11(5,19)d和21(12,36)d;(3)非AKI和AKI患者的住院医疗费用分别为19505(11241,41404)元和44312(19324,93553)元,CA-AKI和HA-AKI的花费分别为51949(23873,106235)元和27400(12982,60964)元;(4)各年龄亚组的AKI都和住院死亡独立相关,在≥18,<75岁、≥75,<80岁、≥80,<85岁、≥85,<90岁和≥90岁年龄亚组,OR值分别为5.540(95%可信区间:4.459~6.883)、4.099(95%可信区间:2.785~6.032)、4.986(95%可信区间:3.556~6.992)、5.885(95%可信区间:3.985~8.692)和4.894(95%可信区间:2.603~9.202)。结论通过分析AKI与住院时长、总住院花费和住院全因死亡之间的关系,发现AKI患者的医疗费用更高,HA-AKI患者的住院时长更长,AKI患者的住院死亡风险更高;在不同的年龄分层,AKI和住院死亡独立相关。Objective To explore the clinical hazards of acute kidney injury(AKI)in Inner Mongolia.Methods The authors retrospectively reviewed the electronic medical records of Inner Mongolia Autonomous Region People’s Hospital and Hohhot First Hospital.AKI was confirmed by the changes in blood creatinine levels according to the guideline of Kidney Disease:Improving Global Outcomes.Results The subjects were divided into five age subgroups of<75 years,≥75,<80 years,≥80,<85 years,≥85,<90 years and≥90 years.Mortality rates were 1.3%、2.4%、3.3%、4.9%、5.9%;Length of hospital stay for non-AKI and AKI patients was 15(11,23)and 17(10,31)days;Length of hospital stay for community-acquired AKI(CA-AKI)and hospital-acquired AKI(HA-AKI)11(5,19)and 21(12,36)days;Inpatient medical expenses of non-AKI and AKI patients 19505(11241,41404)yuan and 44,312(19324,93553)yuan;Hospitalization expenses for CA-AKI and HA-AKI 51,949(23873,106235)and 27,400(12982,60964)yuan;AKI was independently associated with in-hospital mortality in all age subgroups.OR values were 5.540(95%confidence interval 4.459-6.883),4.099(95%confidence interval 2.785-6.032),4.986(95%confidence interval 3.556-6.992),5.885(95%confidence interval 3.985-8.692)and 4.894(95%confidence interval 2.603-9.202).Conclusion Regarding the relationship between AKI and length of stay,total hospital expenses and inhospital all-cause mortality,hospitalization expenses are higher in AKI patients.Patients with HA-AKI have longer hospital stays and AKI patients carry a higher risk of in-hospital mortality.And AKI is independently associated with in-hospital mortality by age stratification.

关 键 词：急性肾损伤 病死率 临床危害 KDIGO指南 

分 类 号：R692[医药卫生—泌尿科学]