Analysis of Risk Factors for Augmented Renal Clearance in Patients with Severe Infection and Severe Trauma
Objective To investigate the risk factors for augmented renal clearance(ARC)in patients with severe infection and severe trauma.Methods A total of 200 patients admitted to the intensive care unit(ICU)and neurosurgery department of the hospital from January to December 2022 were selected,with 100 patients in each department.The patients were divided into the ARC group and non-ARC group based on the presence of ARC or not[endogenous creatinine clearance rate(CCr)≥130 mL/(min·1.73 m2)was evaluated as the presence of ARC].The univariate analysis and binary Logistic regression analysis were used to screen the risk factors that affected the occurrence of ARC,and the predictive value of such risk factors for ARC occurrence was analyzed based on the receiver operating characteristic(ROC)curve.Results Among 100 patients with severe infection,26 had ARC,the age and Sequential Organ Failure Assessment(SOFA)score were the independent risk factors for ARC in patients with severe infection.When the SOFA score was≤five points,the area under the curve(AUC)was 0.870(0.794,0.945),the sensitivity was 96.2%,and the specificity was 73.0%;when the age was≤53 years,the AUC was 0.774(0.673,0.875),the sensitivity was 61.5%,and the specificity was 83.8%.Among 100 patients with severe trauma,54 had ARC,the age and serum creatinine(SCr)were the independent risk factors for ARC in patients with severe trauma.When the age was≤53 years,the AUC was 0.918(0.862,0.974),the sensitivity was 88.9%,and the specificity was 80.4%;when the SCr was≤62 µmol/L,the AUC was 0.765(0.671,0.859),the sensitivity was 72.2%,and the specificity was 69.6%.Conclusion The patients with severe infection aged≤53 years,SOFA score≤five points and the patients with severe trauma aged≤53 years,SCr≤62 µmol/L have a higher risk of ARC,and the standard dose cannot reach the pharmacokinetic/pharmacodynamic target value with the best bactericidal effect.
万方数据
维普
