Risk Factors Analysis And Scoring System Establishment Of Acute Renal Injury In Hospitalized Patients

Objective To identify the risk factors of acute kidney injury(AKI)in hospitalized patients,and to establish a prognostic evaluation system for AKI in hospitalized patients,so as to provide reference for the prevention and treatment of AKI in hospitalized patients.Methods Adult hospitalized patients with AKI from November 2017 to December 2018 in Hulunbuir area were divided into experimental group and verification group.The experimental group was divided into death group and survival group according to whether they died or not.Multivariate logistic regression analysis was used to determine the independent risk factors for AKI mortality.After the independent risk factors are obtained,the score of each risk factor is set according to the OR value of logistic regression results,and the scoring system is finally formed.Then Hosmer-Lemeshow method was used to evaluate the fitness of the scoring system and to evaluate its ability to predict the prognosis of AKI.Results There were significant differences in the number of basic diseases in AKI patients between survival group and death group(P<0.05),but no significant differences in gender and age(P>0.05).The albumin content in the survival group was 34.17+6.84g/L,and in the death group was 31.53±8.27 g/L.The albumin content in the death group was significantly lower than that in the survival group.The leucocyte count in the death group was 13.51±6.19×10~9/L,while that in the survival group was 11.64±5.0×10~9/L.The leucocyte count in the death group was higher than that in the survival group,and the difference was statistically significant(P<0.05).The proportion of extrarenal failure in death group was higher than that in survival group,and the difference was statistically significant(P<0.05).The incidence of oliguria in the death group was 45.9%,while that in the survival group was only 19.1%.The difference was statistically significant(P<0.05).In the death group,28 cases used dopamine(45.9%)and 13 cases used dopamine(13.8%)in the survival group.There were significant differences in dopamine use between the survival group and the death group(P<0.05).43 cases in the death group used diuretics,accounting for 70.5%,39cases in the survival group used diuretics,accounting for 41.5%.There was significant difference between the two groups(P<0.05).In this study,multivariate logistic regression analysis revealed that vasoactive drug use(dopamine),respiratory failure,circulatory failure,nervous system failure and sepsis were independent risk factors for AKI death.According to the OR value,the scoring system was established.By analyzing the scoring intervals and the mortality relationship of the validation group,it was found that the mortality rate of the patients scored between 12 and 16could reach 50%.Meanwhile,the score was positively correlated with the mortality rate.Hosmer-Lemeshow test results showed that the scoring system had a good fit(?~2=9.169,P=0.328)and could predict the prognosis of AKI.Conclusion 1)Vasoactive drug use(dopamine),respiratory failure,circulatory failure,nervous system failure and sepsis are independent risk factors for AKI death.(2)The scoring system can objectively and quantitatively predict the prognosis of AKI in hospitalized patients.The higher the scoring,the higher the mortality rate.The mortality risk of patients scored more than 12 points increased significantly.The mortality rate of patients scored between 12 and 16 points could reach 50%.(3)Early prevention and treatment of sepsis and rational use of vasoactive drugs are helpful to the prevention and treatment of acute kidney injury.