The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort study

Background Both sepsis and AKI are diseases of major concern in intensive care unit (ICU). This study aimed to evaluate the excess mortality attributable to sepsis for acute kidney injury (AKI).Methods A propensity score-matched analysis on a multicenter prospective cohort study in 18 Chinese ICUs w...

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Main Authors: Hui-Miao Jia, Yi-Jia Jiang, Xi Zheng, Wen Li, Mei-Ping Wang, Xiu-Ming Xi, Wen-Xiong Li
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2022.2162415
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author Hui-Miao Jia
Yi-Jia Jiang
Xi Zheng
Wen Li
Mei-Ping Wang
Xiu-Ming Xi
Wen-Xiong Li
author_facet Hui-Miao Jia
Yi-Jia Jiang
Xi Zheng
Wen Li
Mei-Ping Wang
Xiu-Ming Xi
Wen-Xiong Li
author_sort Hui-Miao Jia
collection DOAJ
description Background Both sepsis and AKI are diseases of major concern in intensive care unit (ICU). This study aimed to evaluate the excess mortality attributable to sepsis for acute kidney injury (AKI).Methods A propensity score-matched analysis on a multicenter prospective cohort study in 18 Chinese ICUs was performed. Propensity score was sequentially conducted to match AKI patients with and without sepsis on day 1, day 2, and day 3–5. The primary outcome was hospital death of AKI patients.Results A total of 2008 AKI patients (40.9%) were eligible for the study. Of the 1010 AKI patients with sepsis, 619 (61.3%) were matched to 619 AKI patients in whom sepsis did not develop during the screening period of the study. The hospital mortality rate of matched AKI patients with sepsis was 205 of 619 (33.1%) compared with 150 of 619 (24.0%) for their matched AKI controls without sepsis (p = 0.001). The attributable mortality of total sepsis for AKI patients was 9.1% (95% CI: 4.8–13.3%). Of the matched patients with sepsis, 328 (53.0%) diagnosed septic shock. The attributable mortality of septic shock for AKI was 16.2% (95% CI: 11.3–20.8%, p < 0.001). Further, the attributable mortality of sepsis for AKI was 1.4% (95% CI: 4.1–5.9%, p = 0.825).Conclusions The attributable hospital mortality of total sepsis for AKI were 9.1%. Septic shock contributes to major excess mortality rate for AKI than sepsis.Registration for the multicenter prospective cohort study registration number ChiCTR-ECH-13003934
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spelling doaj-art-514d5cd474e14042b9a026f633cd42762025-08-20T03:48:57ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2022.2162415The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort studyHui-Miao Jia0Yi-Jia Jiang1Xi Zheng2Wen Li3Mei-Ping Wang4Xiu-Ming Xi5Wen-Xiong Li6Department of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, Beijing, ChinaDepartment of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, Beijing, ChinaDepartment of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, ChinaDepartment of Surgical Intensive Critical Unit, Beijing Chao-yang Hospital, Capital Medical University, Beijing, ChinaBackground Both sepsis and AKI are diseases of major concern in intensive care unit (ICU). This study aimed to evaluate the excess mortality attributable to sepsis for acute kidney injury (AKI).Methods A propensity score-matched analysis on a multicenter prospective cohort study in 18 Chinese ICUs was performed. Propensity score was sequentially conducted to match AKI patients with and without sepsis on day 1, day 2, and day 3–5. The primary outcome was hospital death of AKI patients.Results A total of 2008 AKI patients (40.9%) were eligible for the study. Of the 1010 AKI patients with sepsis, 619 (61.3%) were matched to 619 AKI patients in whom sepsis did not develop during the screening period of the study. The hospital mortality rate of matched AKI patients with sepsis was 205 of 619 (33.1%) compared with 150 of 619 (24.0%) for their matched AKI controls without sepsis (p = 0.001). The attributable mortality of total sepsis for AKI patients was 9.1% (95% CI: 4.8–13.3%). Of the matched patients with sepsis, 328 (53.0%) diagnosed septic shock. The attributable mortality of septic shock for AKI was 16.2% (95% CI: 11.3–20.8%, p < 0.001). Further, the attributable mortality of sepsis for AKI was 1.4% (95% CI: 4.1–5.9%, p = 0.825).Conclusions The attributable hospital mortality of total sepsis for AKI were 9.1%. Septic shock contributes to major excess mortality rate for AKI than sepsis.Registration for the multicenter prospective cohort study registration number ChiCTR-ECH-13003934https://www.tandfonline.com/doi/10.1080/0886022X.2022.2162415Sepsisacute kidney injuryattributable mortality
spellingShingle Hui-Miao Jia
Yi-Jia Jiang
Xi Zheng
Wen Li
Mei-Ping Wang
Xiu-Ming Xi
Wen-Xiong Li
The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort study
Renal Failure
Sepsis
acute kidney injury
attributable mortality
title The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort study
title_full The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort study
title_fullStr The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort study
title_full_unstemmed The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort study
title_short The attributable mortality of sepsis for acute kidney injury: a propensity-matched analysis based on multicenter prospective cohort study
title_sort attributable mortality of sepsis for acute kidney injury a propensity matched analysis based on multicenter prospective cohort study
topic Sepsis
acute kidney injury
attributable mortality
url https://www.tandfonline.com/doi/10.1080/0886022X.2022.2162415
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