Interaction of acute heart failure and acute kidney injury on in-hospital mortality of critically ill patients with sepsis: A retrospective observational study

作者全名："Hu, Tianyang; Yao, Wanjun; Li, Yu; Liu, Yanan"

作者地址："[Hu, Tianyang] Chongqing Med Univ, Precis Med Ctr, Affiliated Hosp 2, Chongqing, Peoples R China; [Yao, Wanjun] Wuhan 1 Hosp, Dept Anesthesiol, Wuhan 430030, Hubei, Peoples R China; [Li, Yu] Chongqing Med Univ, Chongqing Bishan Dist Peoples Hosp, Dept Nephrol, Bishan Hosp, Chongqing, Peoples R China; [Liu, Yanan] Jiulongpo Dist Peoples Hosp, Dept Nephrol Rheumatol & Immunol, Chongqing, Peoples R China"

通信作者："Liu, YA (通讯作者)，Jiulongpo Dist Peoples Hosp, Dept Nephrol Rheumatol & Immunol, Chongqing, Peoples R China."

来源：PLOS ONE

ESI学科分类：Multidisciplinary

WOS号：WOS:000948775000045

JCR分区：Q1

影响因子：2.9

年份：2023

卷号：18

期号：3

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结束页：　

文献类型：Article

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摘要："BackgroundThe present study aimed to evaluate the synergistic impact of acute heart failure (AHF) and acute kidney injury (AKI) on in-hospital mortality in critically ill patients with sepsis. MethodsWe undertook a retrospective, observational analysis using data acquired from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and eICU Collaborative Research Database (eICU-CRD). The effects of AKI and AHF on in-hospital mortality were examined using a Cox proportional hazards model. Additive interactions were analyzed using the relative extra risk attributable to interaction. ResultsA total of 33,184 patients were eventually included, comprising 20,626 patients in the training cohort collected from the MIMIC-IV database and 12,558 patients in the validation cohort extracted from the eICU-CRD database. After multivariate Cox analysis, the independent variables for in-hospital mortality included: AHF only (HR:1.20, 95% CI:1.02-1.41, P = 0.005), AKI only (HR:2.10, 95% CI:1.91-2.31, P < 0.001), and both AHF and AKI (HR:3.80, 95%CI:13.40-4.24, P < 0.001). The relative excess risk owing to interaction was 1.49 (95% CI:1.14-1.87), the attributable percentage due to interaction was 0.39 (95%CI:0.31-0.46), and the synergy index was 2.15 (95%CI:1.75-2.63), demonstrated AHF and AKI had a strong synergic impact on in-hospital mortality. And the findings in the validation cohort indicated identical conclusions to the training cohort. ConclusionOur data demonstrated a synergistic relationship of AHF and AKI on in-hospital mortality in critically unwell patients with sepsis."

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