Factors Related to Middle-Long-Term Mortality in Acute Kidney Injury

Yıl 2024, Cilt: 34 Sayı: 4, 445 - 449, 31.08.2024

Yasemin Coşkun Yavuz , Zeynep Bıyık , Muslu Kazım Körez , Lütfullah Altıntepe

https://doi.org/10.54005/geneltip.1360137

Öz

Aim: To determine the clinical and laboratory parameters that affect the mid-long term mortality of patients hospitalized for AKI.
Material and method: Patients hospitalized with the diagnosis of AKI in the intensive care unit and clinic of Nephrology for four years were retrospectively screened. The files of these patients were scanned. Demographic data, comorbidities, vital signs and laboratory parameters were scanned. It was determined in terms of factors affecting mortality in these patients (living and dying) over a 4-year period.
Results: The effects of the variables found to be significant (age, presence of hypertension and coronary artery disease (CAD), sedimentation, C-reactive protein (CRP), urea, potassium (K), magnesium (Mg), pH and CRP-albumin ratio (CAR) by univariate analysis on mortality was performed using multiple logistic regression analysis, which was used to identify the independent risk factors of mortality. Multiple logistic regression analysis using Stepwise selection method revealed that increasing age (IQR=1.04, 95% CI=1.01 – 1.07, p=.004), presence of CAD (IQR =2.16, 95% CI=1.16 – 4.02, p=.016), increased Mg (IQR =2.64, 95% CI=1.18 – 5.92, p=.018) and K (IQR =1.70, 95% CI=1.21 – 2.41, p=.002) were independent risk factors for mortality. The accuracy rate for the predictive performance of this prediction model in predicting mortality was 71.1%, with a sensitivity of 26.5%, a specificity of 90%, and an AUC of 0.753.
Conclusion: In our predictive model, in the medium-long term, we found old age, the presence of coronary artery disease, increased K and Mg as the independent risk factors for mortality in AKI patients.

Anahtar Kelimeler

acute kidney injury, age, comorbidity, mortality

Akut Böbrek Hasarında Orta-Uzun Dönem Mortaliteyle İlişkili Faktörler

Öz

Amaç: ABH nedeniyle hastaneye yatırılan hastaların orta-uzun dönem mortalitesini etkileyen klinik ve laboratuvar parametrelerini belirlemek.
Gereç ve yöntem: AKI tanısıyla yoğun bakım ünitesinde ve Nefroloji kliniğinde dört yıl boyunca yatan hastaların dosyaları geriye dönük olarak tarandı.Demografik veriler, komorbiditeler, vital ve laboratuvar parametreleri incelendi. Bu hastalarda 4 yıllık süreçte mortaliteyi etkileyen faktörler açısından belirlendi.
Bulgular: Tek değişkenli analiz ile anlamlı bulunan değişkenlerin (yaş, hipertansiyon ve koroner arter hastalığı (KAH) varlığı, sedimantasyon, C-reaktif protein (CRP), üre, potasyum (K), magnezyum (Mg), pH ve CRP-albümin oranı (CAR)) mortalite üzerine etkileri , mortalitenin bağımsız risk faktörlerini belirlemek için kullanılan çoklu lojistik regresyon analizi kullanılarak yapıldı. Multipl lojistik regresyon analizi sonucu artan yaş (IQR=1.04, %95 CI=1,01 – 1,07, p=0,004), KAH varlığı (IQR =2,16, 95% CI=1,16 – 4,02, p=0,016), artmış Mg (IQR =2,64, %95 CI=1,18 – 5,92, p) =0,018) ve K (IQR =1,70, 95% GA=1,21 – 2,41, p=0,002) mortalite için bağımsız risk faktörleri olarak saptandı. Bu tahmin modelinin mortaliteyi öngörmedeki prediktif değeri %71,1, sensitivitesi %26,5, sensitivitesi %90 ve AUC 0,753 idi.
Sonuç: Prediktif modelimizde orta-uzun vadede AKI hastalarında ileri yaş, koroner arter hastalığı varlığı, K ve Mg artışını mortalite için bağımsız risk faktörleri olarak bulduk.

Anahtar Kelimeler

akut böbrek hasarı, komorbidite, mortalite, yaş

Kaynakça

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