Analysis on prognostic indicators of acute kidney injury in intensive care uint

Abstract

Objective To determine the prognostic indicators of acute kidney injury by comprehensive anal-ysis of the mortality risk factors for AKI. Method It' s a retrospective study. The clinical date form March 2008 to August 2009 were collected and analyzed, including gender, age,case history of chronic diseases, the worst values of laboratory examinations within 24 hours of diagnosis (including routine blood tests, blood gas analysis, liver andrenal function, the levels of serum CystatinC , blood electrolytes). According to the 60-day survival of the state will be divided into the survival group and dead groups, Calculation acute physiology and Chronic health evaluation (A-PACHE) Ⅱ scores and mortality.First,univariate analysis was used to screen the variables that related to Prognosis,Calculate odds ratios (OR) and 95% confidence interval (CI) .then Proceeded multiple-factor analysis with Logis-tic regression among to Perform the variables. Results Of the 98 acute kidney injury cases analyzed, 60 cases were males and 38 females, age ranged form 19 to 89 years (mean age 52.4± 16.1 years) .The overall mortality was 34.7%(34/98) within 60d of final diagnosis.The APACHE Ⅱ scores of the non-survivors (17.4 ± 4.3) were higher than that of the survivors(14.2±4.8, P ＜ 0.05). The mortality of the patients with high Cystatin C(＞ 1.3mg/L) was 50% (24/48), which was higher than that of the patients with low Cystatin C (＜ 1.3 mg/L)(20%,10/50; P ＜0.05).Tne results of the univariate analysis indicated that Organ failure≥ 2, Oliguria、 A-PACHEI1 ＞ 15 scores,Cys C ＞ 1.3 mg/L Cys C ＞ 1.3 mg/L Combined APACHEⅡ＞ 15 scores,were the risk factors of AKI. However the logistic reggression suggessted that Organ failure≥2, Oliguria, Cys C ＞ 1.3 mg/L Combined APACHEⅡ＞ 15 scores are the independent risk factors of AKI. Conclusions Cys C ＞ 1.3 mg/L Combined APACHE Ⅱ＞ 15 scores may be used for the prognosis the patients AKI. Key words: Intensive Care Unit; Acute kidney injury; Serum Cystatin C; APACHE II ; 01iguria; Prognosis; Retrospective studies