AI Article Synopsis
- The study investigated how acute heart failure (AHF) and acute kidney injury (AKI) together affect the risk of death in critically ill sepsis patients.
- The analysis involved over 33,000 patients and revealed that the combination of AHF and AKI significantly increased the risk of in-hospital mortality compared to either condition alone.
- Findings suggest that healthcare providers should be aware of the dual impact of AHF and AKI when managing critically ill sepsis patients, as their combined presence greatly raises mortality risk.
Article Abstract
Background: The 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.
Methods: We 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.
Results: A 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.
Conclusion: Our data demonstrated a synergistic relationship of AHF and AKI on in-hospital mortality in critically unwell patients with sepsis.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9994701 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0282842 | PLOS |
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