Factors associated with occurrence and severity of acute kidney injury in patients with Sepsis – A retrospective database study

Carter, Adam W.; Engoren, Milo

doi:10.1016/j.jcrc.2022.154150

Cited by 6 publications

(2 citation statements)

References 45 publications

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“…An additional analysis examined the clinical characteristics of patients with a 20% or more increase (or decrease) in CCr. In a previous study, about half of the patients admitted to the ICU developed AKI, with sepsis being the most common etiology at 40-50% [9,22,23]. In this study, 36/61 (59%) patients diagnosed with sepsis had AKI or were on continuous renal replacement therapy.…”

Section: Discussionmentioning

confidence: 46%

Simulation of Vancomycin Exposure Using Trough and Peak Levels Achieves the Target Area under the Steady-State Concentration–Time Curve in ICU Patients

et al. 2023

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The therapeutic drug monitoring (TDM) of vancomycin (VCM) in critically ill patients often results in the estimated area being under the concentration–time curve (AUC) values that deviate from individual observations. In this study, we investigated the factors influencing the achievement of the target AUC of VCM at steady-state in critically ill patients. We retrospectively collected data from patients treated with VCM in an intensive care unit (ICU). Multivariate analysis was used to adjust for significant factors with p < 0.05 and identify new factors affecting the achievement of the target AUC at steady-state for VCM. Among the 113 patients included in this study, 72 (64%) were in the 1-point group (trough only), whereas 41 (36%) were in the 2-point group (trough/peak). The percentage of patients achieving the target AUC at the follow-up TDM evaluation was significantly higher in the two-point group. Multivariate analysis showed that being in the 2-point group and those with a 20% or more increase (or decrease) in creatinine clearance (CCr) were both significantly associated with the success rate of achieving the target AUC at the follow-up TDM. Novel findings revealed that in patients admitted to the ICU, changes in renal function were a predictor of AUC deviation, with a 20% or more increase (or decrease) in CCr being an indicator. We believe the indicators obtained in this study are simple and can be applied clinically in many facilities. If changes in renal function are anticipated, we recommend an AUC evaluation of VCM with a two-point blood collection, close monitoring of renal function, and dose adjustment based on reanalyzing the serum concentrations of VCM.

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Section: Discussionmentioning

confidence: 46%

Simulation of Vancomycin Exposure Using Trough and Peak Levels Achieves the Target Area under the Steady-State Concentration–Time Curve in ICU Patients

et al. 2023

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“…With the introduction of sepsis 3.0, the previous sofa score may not adequately reflect the overall condition of the disease, and further improvement is needed. Over the years, several studies have explored the new risk factors associated with the prognosis of sepsis [ 27 , 28 ]. Two observational studies found serum albumin to be a risk factor for death in patients with sepsis [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Organism type of infection is associated with prognosis in sepsis: an analysis from the MIMIC-IV database

Guo

Cui

et al. 2023

BMC Infect Dis

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Background Sepsis has a high mortality rate, which is expensive to treat, and is a major drain on healthcare resources; it seriously impacts the quality of human life. The clinical features of positive or non-positive blood cultures have been reported, but the clinical features of sepsis with different microbial infections and how they contribute to clinical outcomes have not been adequately described. Methods We extracted clinical data of septic patients with a single pathogen from the online Medical Information Mart for Intensive Care(MIMIC)-IV database. Based on microbial cultures, patients were classified into Gram-negative, Gram-positive, and fungal groups. Then, we analyzed the clinical characteristics of sepsis patients with Gram-negative, Gram-positive, and fungal infections. The primary outcome was 28-day mortality. The secondary outcomes were in-hospital mortality, the length of hospital stay, the length of ICU stay, and the ventilation duration. In addition, Kaplan–Meier analysis was used for the 28-day cumulative survival rate of patients with sepsis. Finally, we performed further univariate and multivariate regression analyses for 28-day mortality and created a nomogram for predicting 28-day mortality. Results The analysis showed that bloodstream infections showed a statistically significant difference in survival between Gram-positive and fungal organisms; drug resistance only reached statistical significance for Gram-positive bacteria. Through univariate and multivariate analysis, it was found that both the Gram-negative bacteria and fungi were independent risk factors for the short-term prognosis of sepsis patients. The multivariate regression model showed good discrimination, with a C-index of 0.788. We developed and validated a nomogram for the individualized prediction of 28-day mortality in patients with sepsis. Application of the nomogram still gave good calibration. Conclusions Organism type of infection is associated with mortality of sepsis, and early identification of the microbiological type of a patient with sepsis will provide an understanding of the patient's condition and guide treatment.

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Impact of severe acute kidney injury on short-term mortality in urosepsis

Fujita,

Momota,

Soma

et al. 2024

World J Urol

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Factors associated with occurrence and severity of acute kidney injury in patients with Sepsis – A retrospective database study

Cited by 6 publications

References 45 publications

Simulation of Vancomycin Exposure Using Trough and Peak Levels Achieves the Target Area under the Steady-State Concentration–Time Curve in ICU Patients

Simulation of Vancomycin Exposure Using Trough and Peak Levels Achieves the Target Area under the Steady-State Concentration–Time Curve in ICU Patients

Organism type of infection is associated with prognosis in sepsis: an analysis from the MIMIC-IV database

Impact of severe acute kidney injury on short-term mortality in urosepsis

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