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Risk of developing severe sepsis after acute kidney injury: a population-based cohort study

机译：一项基于人群的队列研究显示急性肾损伤后出现严重败血症的风险

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IntroductionSepsis has been a factor of acute kidney injury (AKI); however, little is known about dialysis-requiring AKI and the risk of severe sepsis after survival to discharge.MethodsWe conducted a population-based cohort study based on the Taiwan National Health Insurance Research Database from 1999 to 2009. We identified patients with AKI requiring dialysis during hospitalization and survived for at least 90 days after discharge, and matched them with those without AKI according to age, sex, and concurrent diabetes. The primary outcome was severe sepsis, defined as sepsis with a diagnosis of acute organ dysfunction. Individuals who recovered enough to survive without acute dialysis were further analyzed.ResultsWe identified 2983 individuals (mean age, 62 years; median follow-up, 3.96 years) with dialysis-requiring AKI and 11,932 matched controls. The incidence rate of severe sepsis was 6.84 and 2.32 per 100 person-years among individuals with dialysis-requiring AKI and without AKI in the index hospitalization, respectively. Dialysis-requiring AKI patients had a higher risk of developing de novo severe sepsis than the non-AKI group. In subgroup analysis, even individuals with recovery from dialysis-requiring AKI were at high risk of developing severe sepsis.ConclusionsAKI is an independent risk factor for severe sepsis. Even patients who recovered from AKI had a high risk of long-term severe sepsis.
机译：简介败血症一直是急性肾损伤（AKI）的一个因素;方法：我们从1999年至2009年基于台湾国家健康保险研究数据库进行了一项基于人群的队列研究。我们确定了需要透析的AKI患者，这些患者需要透析在住院期间可生存，出院后至少存活90天，并根据年龄，性别和并发糖尿病将其与无AKI的患者相匹配。主要结局为严重败血症，定义为诊断为急性器官功能障碍的败血症。结果我们确定了2983例需要透析的AKI患者和11,932例匹配的对照组，这些患者有足够的生存能力，无需进行急性透析就可以生存，平均年龄62岁;中位随访时间3.96年。在需要住院透析的AKI患者和没有AKI患者中，严重败血症的发生率分别为每100人年6.84和2.32。与非AKI组相比，需要透析的AKI患者发生新发严重脓毒症的风险更高。在亚组分析中，即使从需要透析的AKI中恢复的个体也有发生严重败血症的高风险。结论AKI是发生严重败血症的独立危险因素。即使从AKI康复的患者也有长期严重败血症的高风险。

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