Risk Factors And Prognosis Of Acute Kidney Injury In Elderly Patients With Sepsis In ICU

ObjectiveThe aim of this study was to investigate risk factors and prognosis of acute kidney injury (AKI) in elderly patients with sepsis in ICU.MethodsClinical data of 108 elderly patients diagnosed as sepsis, admitted in intensive care unit of First Affiliated Hospital, Zhejiang University College Of Medicine and Ningbo Medical Treatment Center Lihuili Hospital from May 2010 to May 2014, were analyzed retrospectively. According to patients who developed AKI or not, they were divided into two groups to compare the clinical characteristics, laboratory and physiologic data. Multivariate logistic regression analysis was used to investigate the independent risk factors of AKI in these patients. Clinical characteristics, prognosis of elderly patients with sepsis were retrospectively analyzed.ResultsOf the total 108 elderly patients with sepsis in ICU,60 patients developed AKI and the incidence was 55.6%. Mean arterial pressure (t=4.536) and baseline glomerular filtration rate (t=3.28) were lower in the AKI group than in non-AKI group. Prothrombin time counts(t=3.053), MODS score (1=2.201), APACHE II sore(t=3.423), the frequency of septic shock(χ2=5.4) and surgical operation within two weeks (χ2=5.625) were significantly higher in the AKI group than non-AKI group (all P<0.05). Multivariate logistic regression analysis showed that MODS score(OR=2.039) were independent risk factors of AKI. Higher mean arterial pressure (OR=0.833) and higher baseline glomerular filtration rate (OR=0.776) were associated with a decreased risk of AKI.Hospital mortality was significantly greater in patients who developed AKI(41.7 versus 21.5%). Length of stay in the ICU and hospital was longer in patients who suffered AKI (p=0.026, p=0.042 respectively).ConclusionsElderly patients with sepsis easy to induce the onset of acute kidney injury.Hospital mortality of AKI were higher in patients AKI who developed sepsis.Higher MODS score was independent risk factors of AKI. Higher baseline GFR and higher MAP were associated with a decreased risk of AKI.