Effect and Prognostic Factors of Continuous Blood Purification in Patients with Sepsis Complicated with Acute Kidney Injury
Objective To investigate the effect and prognostic factors of continuous blood purification in patients with sepsis complicated with acute kidney injury.Methods A total of 250 patients with sepsis complicated with acute kidney injury were included in this study from May 2019 to May 2022.All patients were from Zhumadian Downtown Hospital for retrospective analysis.All patients received continuous blood purification treatment,and the outcomes of patients at 28 days were recorded,and they were divided into death group(133 cases)and survival group(117 cases).The baseline data of patients in the death group and the survival group were counted and compared,and then a multivariate regression analysis model was carried out to screen the high-risk factors for poor prognosis.Results The scores of APACHE Ⅱ,SOFA and invasive mechanical ventilation in the death group were higher than those in the survival group(t=5.824,5.311,x2=49.209,all P＜0.05).Compared with the survival group,the levels of diabetes,coronary heart disease,AKI stage Ⅲ,septic shock,cardiac function grade Ⅳ,hyperkalemia,severe metabolic acidosis and CRP indexes in the death group were all higher.The length of ICU stay in the death group was longer than that in the survival group(x 2=49.079,30.401,42.549,26.737,35.800,29.709,30.682,22.654,62.850).t=7.412,9.605,both P＜0.05),but there were no significant differences in gender,BMI,proportion of hypertension and hemoglobin index between the two groups(all P＞0.05).The risk factors for poor prognosis of patients with sepsis complicated with acute kidney injury by continuous blood purification were age,coronary heart disease,AKI stage Ⅲ,septic shock,cardiac function grade Ⅳ,hyperkalemia,APACHE Ⅱ score,SOFA score(OR=1.391,7.838,7.360,8.306,8.793,3.473,2.832,3.543,all P＜0.05).Conclusion The high risk factors for poor prognosis of patients with sepsis complicated with acute kidney injury by continuous blood purification include age,coronary heart disease,AKI stage Ⅲ,septic shock,cardiac function grade Ⅳ,hyperkalemia,etc.Relevant clinical measures should be taken to improve the prognosis of patients.
万方数据
维普
