Value of Development and Validation of Risk-Adjusted Outcomes for Systems of Emergency Medical Carel combined with lactate clearance rate in evaluating acute kidney injury complicated by patients with multiple injuries
10.3760/cma.j.cn431274-20240808-01216
- VernacularTitle:急救系统风险预测模型联合乳酸清除率对多发伤患者并发急性肾损伤的评估价值
- Author:
Jiaqi YE
1
;
Fangming ZHOU
;
Bin ZHU
Author Information
1. 浙江中医药大学护理学院，杭州 310000
- Publication Type:Journal Article
- Keywords:
Acute kidney injury;
Development and Validation of Risk-Adjusted Outcomes for Systems of Emergency Medical Care;
Lactate clearance rate;
Polytrauma
- From:
Journal of Chinese Physician
2025;27(9):1340-1344
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of the Development and Validation of Risk-Adjusted Outcomes for Systems of Emergency Medical Care (DAVROS) combined with lactate clearance rate in evaluating acute kidney injury (AKI) complicated by patients with multiple injuries.Methods:A total of 85 patients with multiple injuries admitted to the Lishui People′s Hospital from March 2021 to March 2024 were selected as the research objects. They were divided into the AKI group ( n=24) and non-AKI group ( n=61) according to whether AKI occurred. The DAVROS scores and lactate clearance rates of the two groups were analyzed. Multivariate regression analysis was used to determine the independent risk factors affecting the occurrence of AKI, and the receiver operating characteristic (ROC) curve was used to evaluate the combined predictive value of the prediction model and lactate clearance rate. Results:One-way analysis of variance showed that the age, history of diabetes, hemorrhagic shock, use of diuretics, and DAVROS score in the AKI group were higher than those in the non-AKI group (all P<0.05). The albumin and lactate clearance rate in the AKI group were lower than those in the non-AKI group (all P<0.05). Multivariate regression analysis showed that advanced age, history of diabetes, hemorrhagic shock, use of diuretics, high lactate level, and high DAVROS score were independent risk factors for AKI in patients with multiple injuries (all P<0.05). High albumin level and high lactate clearance rate were protective factors for AKI in patients with multiple injuries (all P<0.05). ROC curve analysis showed that the combination of DAVROS score and lactate clearance rate had high value in predicting AKI in patients with multiple injuries, with an AUC of 0.938, a sensitivity of 91.7%, and a specificity of 86.9%. Conclusions:The DAVROS combined with lactate clearance rate has important value in evaluating AKI complicated by patients with multiple injuries, and can be used as an important reference for early clinical diagnosis and treatment decisions.
