Objective: This study aimed to explore the association between base excess (BE) and the risk of 30-day mortality among patients with acute kidney injury (AKI) in the intensive care unit (ICU).Methods: This retrospective study included patients with AKI from the Medical Information Mart for Intensive Care (MIMIC)-IV database. We used a multivariate Cox proportional-hazards model to obtain the hazard ratio (HR) for the risk of 30-day mortality among patients with AKI. Furthermore, we utilized a Cox proportional-hazard model with restricted cubic splines (RCS) to explore the potential non-linear associations.Results: Among the 14,238 ICU patients with AKI, BE showed a U-shaped relationship with risk of 30-day mortality for patients with AKI, and higher or lower BE values could increase the risk. Compared with normal base excess (−3~3 mEq/L), patients in different groups (BE ≤ −9 mEq/L, −9 mEq/L < BE ≤ −3 mEq/L, 3 mEq/L < BE ≤ 9 mEq/L, and BE > 9 mEq/L) had different HRs for mortality: 1.57 (1.40, 1.76), 1.26 (1.14, 1.39), 0.97 (0.83, 1.12), 1.53 (1.17, 2.02), respectively. The RCS analyses also showed a U-shaped curve between BE and the 30-day mortality risk.Conclusion: Our results suggest that higher and lower BE in patients with AKI would increase the risk of 30-day mortality. BE measured at administration could be a critical prognostic indicator for ICU patients with AKI and provide guidance for clinicians.

Purpose: To evaluate the association of prior to intensive care unit (ICU) statin use with the clinical outcomes in critically ill patients with acute kidney injury (AKI).Materials and Methods: Patients with AKI were selected from the Medical Information Mart for Intensive Care IV (version 1.0) database for this retrospective observational study. The primary outcome was 30-day intensive care unit (ICU) mortality. A 30-day in-hospital mortality and ICU length of stay (LOS) were considered as secondary outcomes. Comparison of mortality between pre-ICU statin users with non-users was conducted by the multivariate Cox proportional hazards model. Comparison of ICU LOS between two groups was implemented by multivariate linear model. Three propensity score methods were used to verify the results as sensitivity analyses. Stratification analyses were conducted to explore whether the association between pre-ICU statin use and mortality differed across various subgroups classified by sex and different AKI stages.Results: We identified 3,821 pre-ICU statin users and 9,690 non-users. In multivariate model, pre-ICU statin use was associated with reduced 30-day ICU mortality rate [hazard ratio (HR) 0.68 (0.59, 0.79); p < 0.001], 30-day in-hospital mortality rate [HR 0.64 (0.57, 0.72); p < 0.001] and ICU LOS [mean difference −0.51(−0.79, −0.24); p < 0.001]. The results were consistent in three propensity score methods. In subgroup analyses, pre-ICU statin use was associated with decreased 30-day ICU mortality and 30-day in-hospital mortality in both sexes and AKI stages, except for 30-day ICU mortality in AKI stage 1.Conclusion: Patients with AKI who were administered statins prior to ICU admission might have lower mortality during ICU and hospital stay and shorter ICU LOS.

ObjectivesTo understand the knowledge, attitude and behaviour of general practitioners (GPs) towards COVID-19 and to provide evidence for improved prevention and control measures against the pandemic.Study designA cross-sectional study was conducted with 1018 GPs in Shanghai from 21 February to 2 March 2020 using the WeChat platform.MethodsStratified random cluster sampling was performed according to the regional division of urban, urban–rural fringe and rural areas. This study used a self-designed mobile questionnaire. The questionnaire collected information on knowledge, attitudes and behaviours regarding COVID-19 prevention and control.ResultsA total of 989 questionnaires were declared valid. The average scores of GPs’ knowledge, attitude and behaviour towards COVID-19 were 6.14±1.42 (range 0–10), 13.59±4.42 (range 0–25) and 7.82±1.53 (range 0–10), respectively. Multiple linear regression analysis showed that the knowledge score of male GPs was lower than that of female GPs (p=0.002). In addition, the ‘attitude’ score of female GPs was higher than that of male GPs (p=0.004). The ‘behaviour’ score of GPs in urban areas was lower than that of GPs in urban–rural fringe areas (p<0.001). The higher the knowledge score, the higher the behavioural score was observed to be (p<0.001).ConclusionsThe scores of knowledge, attitude and behaviour of Shanghai GPs towards COVID-19 were limited at the beginning of the COVID-19 outbreak. As a hopeful measure, the early implementation of proper training programmes for GPs in times of crisis will contribute to disease control and prevention. Lessons learnt from the current pandemic will hopefully help GPs handle similar future challenges and potential novel pandemics.

Objective This study aimed to explore the association between base excess (BE) and risk of 30-day mortality among patients with acute kidney injury (AKI) in ICU.Methods This retrospective study including ICU patients with AKI from Medical Information Mart for Intensive Care (MIMIC)-IV database. We used multivariate Cox proportional-hazards model to calculate the hazard ratio (HR) for risk of 30-day mortality among patients with AKI. Furthermore, we utilized Cox proportional-hazard model with restrict cubic splines (RCS) to explore the potential no-linear association. Results Of all the 14238 ICU patients with AKI, BE showed U-shaped relationship with risk of 30-day mortality for patients with AKI, and higher or lower BE value could increase the risk. Compared with normal base excess (-3~3 mmol/L), patients with difference groups (BE ≤ -9mmol/L, -9 mmol/L <BE≤-3 mmol/L, 3 mmol/L <BE≤9 mmol/L and BE＞9 mmol/L) had different HR for mortality: 1.57(1.40,1.76), 1.26(1.14,1.39), 0.97(0.83,1.12), 1.53(1.17,2.02) respectively. And the RCS analyses also showed U-shaped curve between BE and 30-day mortality risk.Conclusion Our results suggest both higher and lower BE in patients with AKI would increase the risk of 30-day mortality. BE measured at administration could be a critical prognostic indicator for ICU patients with AIK and provide guidance for clinicians.

Background Kidney stones are common, frequently occurring worldwide. Some studies have analysed the relationship between dyslipidaemia and kidney stone occurrence but produced inconsistent results due to shortcomings such as small sample sizes, sampling bias, and limited data acquisition. Therefore, correlation studies with sufficient data sources, wide coverage, and strong representation must be carried out. Methods Samples used in our study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007–2016 database. Patients were divided into kidney stone and non-kidney stone groups according to an NHANES standardized question: “Have you ever had kidney stones?” Data on serum total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and the TC/HDL-C ratio were gathered from the two groups. Weighted Mann‒Whitney U tests, weighted chi-square tests, and weighted univariate and multivariable logistic regression analyses were used to analyse the relationship between dyslipidaemia and kidney stone occurrence. Results In total, 10,753 participants were included. TG, TC/HDL-C, and the percentage of individuals with abnormal TG or HDL-C were significantly higher in the stone group than in the non-stone group, and HDL-C levels were significantly lower in the stone group than in the non-stone group. Univariate and multivariate weighted logistic regression analyses indicated that TG and HDL-C abnormalities and high TC/HDL-C levels might be related to increased kidney stone risk (all P for trend < 0.05). Subgroup analyses after stratifying the overall data by age group, sex, and BMI showed that the effects of TG abnormality and TC/HDL-C level on kidney stone risk varied by age group and BMI, while the effect of HDL-C abnormality on the risk of kidney stones only varied by age group. Conclusion TG, HDL-C, and TC/HDL-C are related to a history of kidney stones in US adults. Dyslipidaemia may increase kidney stone prevalence. Further prospective and mechanistic studies are needed to verify the causal roles and pathogenesis.