Association between hyperglycemia at ICU admission and postoperative acute kidney injury in patients undergoing cardiac surgery:Analysis of the MIMIC-IV database
Association between hyperglycemia at ICU admission and postoperative acute kidney injury in patients undergoing cardiac surgery: Analysis of the MIMIC-IV database作者机构:Department of Critical Care MedicineZhongnan Hospital of Wuhan UniversityWuhanHubeiChina Clinical Research Center of Hubei Critical Care MedicineWuhanHubeiChina Department of Critical Care MedicineSir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouZhejiangChina
出 版 物:《Journal of Intensive Medicine》 (重症医学(英文))
年 卷 期:2024年第4卷第4期
页 面:526-536页
核心收录:
学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 1011[医学-护理学(可授医学、理学学位)] 10[医学]
基 金:supported by the National Natural Science Foundation of China(ZP,No.81971816 and 82272208) the Translational Medicine and Interdisciplinary Research Joint Fund of Zhongnan Hospital of Wuhan University(BH No.ZNJC202011) the Subject Cultivation Project of Zhongnan Hospital of Wuhan University(ZP No.ZNXKPY2021001,BH No.ZNXKPY2021002)
主 题:Hyperglycemia Cardiac surgery Acute kidney injury Mortality MIMIC database
摘 要:Background:This study aimed to explore the correlation between hyperglycemia at intensive care unit(ICU)admission and the incidence of acute kidney injury(AKI)in patients after cardiac ***:We conducted a retrospective cohort study,in which clinical data were extracted from the Medical Information Mart for Intensive Care(MIMIC)-IV ***(≥18 years)in the database who were admitted to the cardiovascular intensive care unit after cardiac surgery were *** primary outcome was the incidence of AKI within 7 days following ICU *** outcomes included ICU mortality,hospital mortality,ICU length of stay,and the 28-day and 90-day *** Cox regression analysis was used to assess the association between ICU-admission hyperglycemia and AKI incidence within 7 days of ICU *** adjustment strategies were used to adjust for potential *** were divided into three groups according to their highest blood glucose levels recorded within 24 h of ICU admission:no hyperglycemia(140 mg/dL),mild hyperglycemia(140-200 mg/dL),and severe hyperglycemia(≥200 mg/dL).Results:Of the 6905 included patients,2201(31.9%)were female,and the median(IQR)age was 68.2(60.1-75.9)*** all,1836(26.6%)patients had severe *** incidence of AKI within 7 days of ICU admission,ICU mortality,and hospital mortality was significantly higher in patients with severe admission hyperglycemia than those with mild hyperglycemia or no hyperglycemia(80.3%vs.73.6% and 61.2%,respec-tively;2.8%vs.0.9% and 1.9%,respectively;and 3.4%vs.1.2% and 2.5%,respectively;all P0.001).Severe hyperglycemia was a risk factor for 7-day AKI(Model 1:hazard ratio[HR]=1.4809,95%confidence interval[CI]:1.3126 to 1.6707;Model 2:HR=1.1639,95%CI:1.0176 to 1.3313;Model 3:HR=1.2014,95%CI:1.0490 to 1.3760;all P0.050).Patients with normal glucose levels(glucose levels140 mg/dL)had a higher 28-day mortality rate than those with severe hyperglycemia