Analysis of risk factors for acute kidney injury in patients with non-ST-segment elevation myocardial infarction
10.3760/cma.j.issn.1671-0282.2016.03.018
- VernacularTitle:非ST段抬高型急性心肌梗死患者急性肾损伤危险因素分析
- Author:
Zongqun CAI
;
Qinggao LIAO
;
Xuwu GUO
;
Zengjie WEN
;
Xiaomin OU
;
Senrong LU
- Publication Type:Journal Article
- Keywords:
Emergency department;
Acute myocardial infarction;
Acute kidney injury;
Risk factors;
Prediction score system
- From:Chinese Journal of Emergency Medicine
2016;25(3):343-348
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for acute kidney injury (AKI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI),and to establish a prediction score system for AKI.Methods Totally 296 patients with NSTEMI,who were admitted to the emergency room and further transferred to the Cardiovascular Department in Shantou Central Hospital,were enrolled during January 2011 to April 2014.All patients were divided into AKI group and non-AKI group.Demographics,clinical data and laboratory examinations were collected before and after AKI.AKI risk factors and its OR values were determined after statistically analyzed data by One-Way ANOVA,multivariate logistic regression analysis.Prediction score system for AKI was further established by area under the ROC curve and Hosmer-Lemeshow goodness of fit tests.Results For total 296 patients,the incidence of AKI was 18.4％,including 35 (64.8％) patients in stage Ⅰ,12 (22.2％) patients in stage Ⅱ and 7 (13.0％) patients in stage Ⅲ.Logistic analysis showed that age,heart function (Killip),anemia,the time to emergency department after AMI attack,and absence β-blocker were independent factors associated with AKI.Prediction score system was established which the highest score was 13.A risk score of 3.5 points was determined by Youden' s index,as the optimal cut-off for predict AKI.Patients with ≤3.0 points were considered at low risk,and ≥4.0 points were considered at high risk for AKI.The prediction score system of AKI showed adequate discrimination (area under ROC curve was 0.806) and calibration (Hosmer-Lemeshow statistic test,P =O.503).Conclusions Age,heart function (Killip),anemia,the time to emergency department after AMI attack,and absence β-blocker were independent factors associated with AKI.The clinical prediction score system may help clinicians to make pre-intervention for NSTEMI patients with high AKI risk.
