Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model
Autor(a) principal: | |
---|---|
Data de Publicação: | 2023 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2023000200006 |
Resumo: | Abstract Introduction: Acute kidney injury (AKI) is a frequent complication of community-acquired pneumonia (CAP). Nonetheless, the underlying pathophysiology is not fully understood. Certain factors have shown association with increased risk, but there is still data lacking. The main objective of this study was to identify factors associated with AKI in CAP. Methods: We conducted a retrospective study in patients with confirmed CAP, admitted to an Internal Medicine department within a period of 1 year, presenting with or without AKI on admission. We performed comparative statistics between non-AKI and AKI patients, univariate and multivariable logistic regression with odds ratio (OR) calculation, and survival analysis. Results: This study included 578 patients, of which 52.4% were male, had a mean age of 81.70±11.54 years, and 41.3% had AKI. The mean age was higher in the AKI group (p <0.001), with no differences for gender. In the univariate analysis, several comorbidities, drugs, diastolic blood pressure and some gasometric parameters showed association with AKI. The multivariable analysis selected seven variables as independent associated factors: age (OR 1.027), hyperuricemia (OR 1.990), chronic kidney disease (OR 3.138), diuretic (OR 1.555), statin (OR 1.805), diastolic blood pressure (OR 0.978) and serum lactate (OR 1.350), enabling the development of an AKI probabilistic model with a specificity of 81.1%. Conclusion: This study confirmed previous findings and identified new factors associated with AKI, namely serum lactate. The multivariable model represents a starting point for the creation of true predictive indexes of AKI in CAP with clinical applicability and impact on the therapeutic approach and prognosis. |
id |
RCAP_3396809da6929f90ae0e99589d4a4502 |
---|---|
oai_identifier_str |
oai:scielo:S0872-671X2023000200006 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical ModelAcute Kidney Injury/diagnosisAcute Kidney Injury/etiologyCommunity-Acquired Infections/complicationsPneumonia/complicationsPrognosisAbstract Introduction: Acute kidney injury (AKI) is a frequent complication of community-acquired pneumonia (CAP). Nonetheless, the underlying pathophysiology is not fully understood. Certain factors have shown association with increased risk, but there is still data lacking. The main objective of this study was to identify factors associated with AKI in CAP. Methods: We conducted a retrospective study in patients with confirmed CAP, admitted to an Internal Medicine department within a period of 1 year, presenting with or without AKI on admission. We performed comparative statistics between non-AKI and AKI patients, univariate and multivariable logistic regression with odds ratio (OR) calculation, and survival analysis. Results: This study included 578 patients, of which 52.4% were male, had a mean age of 81.70±11.54 years, and 41.3% had AKI. The mean age was higher in the AKI group (p <0.001), with no differences for gender. In the univariate analysis, several comorbidities, drugs, diastolic blood pressure and some gasometric parameters showed association with AKI. The multivariable analysis selected seven variables as independent associated factors: age (OR 1.027), hyperuricemia (OR 1.990), chronic kidney disease (OR 3.138), diuretic (OR 1.555), statin (OR 1.805), diastolic blood pressure (OR 0.978) and serum lactate (OR 1.350), enabling the development of an AKI probabilistic model with a specificity of 81.1%. Conclusion: This study confirmed previous findings and identified new factors associated with AKI, namely serum lactate. The multivariable model represents a starting point for the creation of true predictive indexes of AKI in CAP with clinical applicability and impact on the therapeutic approach and prognosis.Sociedade Portuguesa de Medicina Interna2023-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2023000200006Medicina Interna v.30 n.2 2023reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2023000200006Teles,CarolinaMagalhães,AnaCosta,Tiago Dias daBarra,CátiaSilva,Ana LuísaAlbuquerque,FernandoGaspar,ElsaSantos,Lèlitainfo:eu-repo/semantics/openAccess2024-02-06T17:08:41Zoai:scielo:S0872-671X2023000200006Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:20:58.463183Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model |
title |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model |
spellingShingle |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model Teles,Carolina Acute Kidney Injury/diagnosis Acute Kidney Injury/etiology Community-Acquired Infections/complications Pneumonia/complications Prognosis |
title_short |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model |
title_full |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model |
title_fullStr |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model |
title_full_unstemmed |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model |
title_sort |
Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model |
author |
Teles,Carolina |
author_facet |
Teles,Carolina Magalhães,Ana Costa,Tiago Dias da Barra,Cátia Silva,Ana Luísa Albuquerque,Fernando Gaspar,Elsa Santos,Lèlita |
author_role |
author |
author2 |
Magalhães,Ana Costa,Tiago Dias da Barra,Cátia Silva,Ana Luísa Albuquerque,Fernando Gaspar,Elsa Santos,Lèlita |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Teles,Carolina Magalhães,Ana Costa,Tiago Dias da Barra,Cátia Silva,Ana Luísa Albuquerque,Fernando Gaspar,Elsa Santos,Lèlita |
dc.subject.por.fl_str_mv |
Acute Kidney Injury/diagnosis Acute Kidney Injury/etiology Community-Acquired Infections/complications Pneumonia/complications Prognosis |
topic |
Acute Kidney Injury/diagnosis Acute Kidney Injury/etiology Community-Acquired Infections/complications Pneumonia/complications Prognosis |
description |
Abstract Introduction: Acute kidney injury (AKI) is a frequent complication of community-acquired pneumonia (CAP). Nonetheless, the underlying pathophysiology is not fully understood. Certain factors have shown association with increased risk, but there is still data lacking. The main objective of this study was to identify factors associated with AKI in CAP. Methods: We conducted a retrospective study in patients with confirmed CAP, admitted to an Internal Medicine department within a period of 1 year, presenting with or without AKI on admission. We performed comparative statistics between non-AKI and AKI patients, univariate and multivariable logistic regression with odds ratio (OR) calculation, and survival analysis. Results: This study included 578 patients, of which 52.4% were male, had a mean age of 81.70±11.54 years, and 41.3% had AKI. The mean age was higher in the AKI group (p <0.001), with no differences for gender. In the univariate analysis, several comorbidities, drugs, diastolic blood pressure and some gasometric parameters showed association with AKI. The multivariable analysis selected seven variables as independent associated factors: age (OR 1.027), hyperuricemia (OR 1.990), chronic kidney disease (OR 3.138), diuretic (OR 1.555), statin (OR 1.805), diastolic blood pressure (OR 0.978) and serum lactate (OR 1.350), enabling the development of an AKI probabilistic model with a specificity of 81.1%. Conclusion: This study confirmed previous findings and identified new factors associated with AKI, namely serum lactate. The multivariable model represents a starting point for the creation of true predictive indexes of AKI in CAP with clinical applicability and impact on the therapeutic approach and prognosis. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-06-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2023000200006 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2023000200006 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2023000200006 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Medicina Interna v.30 n.2 2023 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799137296775118848 |