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Initial 24-h perfusion index of ICU admission is associated with acutekidney injury in perioperative critically ill patients: A retrospective cohortanalysis 被引量:1
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作者 Shengjun Liu Longxiang Su +2 位作者 changjing zhuge Huaiwu He Yun Long 《Journal of Intensive Medicine》 CSCD 2023年第3期261-267,共7页
Background:The relationship between perfusion index(PI)and organ dysfunction in patients in the intensivecare unit(ICU)is not clear.This study aimed to explore the relationship between PI and renal function in theperi... Background:The relationship between perfusion index(PI)and organ dysfunction in patients in the intensivecare unit(ICU)is not clear.This study aimed to explore the relationship between PI and renal function in theperioperative critical care setting and evaluate the predictive efficiency of PI on patients with acute kidney injury(AKI)in the ICU.Methods:This retrospective analysis involved 12,979 patients who had undergone an operation and were admitted to the ICU in Peking Union Medical College Hospital from January 2014 to December 2019.The distributionof average PI in the first 24 h after ICU admission and its correlation with AKI was calculated by Cox regression.Receiver operating characteristic(ROC)curves were generated to compare the ability of PI,mean arterial pressure(MAP),creatinine,blood urea nitrogen(BUN),and central venous pressure(CVP)to discriminate AKI in thefirst 48 h in all perioperative critically ill patients.Results:Average PI in the first 24 h served as an independent protective factor of AKI(Odds ratio[OR]=0.786,95%confidence interval[CI]:0.704–0.873,P<0.0001).With a decrease in PI by one unit,the incidence of AKIincreased 1.74 times.Among the variables explored for the prediction of AKI(PI,MAP,creatine,BUN,and CVP),PI yielded the highest area under the ROC curve,with a sensitivity of 64.34%and specificity of 70.14%.A cut-offvalue of PI≤2.12 could be used to predict AKI according to the Youden index.Moreover,patients in the low PIgroup(PI≤2.12)exhibited a marked creatine elevation at 24–48 h with a slower decrease compared with thosein the high PI group(PI>2.12).Conclusions:As a local blood flow indicator,the initial 24-h average PI for perioperative critically ill patients canpredict AKI during their first 120 h in the ICU. 展开更多
关键词 Perfusion index Acute kidney injury PERIOPERATIVE
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