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
基金This work was supported by the Excellence Program of Key Clinical Specialty of Beijing in 2020,Beijing Municipal Science and Technology Commission(grant number:Z201100005520051)China Health Information and HealthCare Big Data Association Severe Infection Analgesia and Sedation Big Data Special Fund(grant number:Z-2019-1-001)+2 种基金China International Medical Foundation Analgesia and Sedation Special Fund(grant number:Z-2017-24-2028-01)National NaturalScience Foundation of China(grant number:11801020)Beijing Municipal Natural Science Foundation(grant number:7192163).
文摘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.