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응급실로 내원한 패혈성 쇼크 환자에서의 급성 신 손상 발생의 예측 인자로서 젖산/알부민 비율의 유용성

Other Titles
 Lactate/albumin ratio for the prediction of the development of sepsis-induced acute kidney injury in the emergency department 
Authors
 이정우  ;  유제성  ;  정성필  ;  좌민홍  ;  공태영  ;  고동률  ;  황윤정  ;  이용희  ;  박인철  ;  김시내 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.30(1) : 22-32, 2019 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2019
Keywords
Sepsis ; Acute kidney injury ; Lactic acid ; Albumins ; Prognosis
Abstract
Objective: The early prediction of acute kidney injury (AKI) in sepsis and the provision of prompt treatment may improve the outcomes. This study investigated the efficacy of the lactate/albumin ratio (LAR) in predicting severe AKI in cases of septic shock. Method: This retrospective, observational cohort study was performed on patients integrated prospectively in a critical pathway of early-goal-directed therapy (EGDT)/SEPSIS. Adult patients with septic shock, who were admitted to the emergency department with a normal kidney function or stage 1 disease based on the Acute Kidney Injury Network classification between January 1, 2014 and September 30, 2017, were analyzed. The outcomes were the development of sepsis-induced severe AKI within 7 days. Results: A total of 343 patients were enrolled. An increase in the LAR value at admission (odds ratio [OR], 1.85; P=0.001) was a strong independent predictor of the development of severe AKI. The increasing predictability of AKI was closely associated with a L/A ratio≥0.794 at admission (OR, 14.66; P<0.001). The area under the receiver operating characteristic curve value of the L/A ratio (0.821; 95% confidence interval [CI], 0.774-0.861; P<0.01) was higher than that of lactate (0.795; 95% CI, 0.747-0.838; P<0.01) for predicting severe AKI (P=0.032). Conclusion: L/A ratio was found to be an independent predictor of the development of severe AKI in septic shock. The prognostic performance of the L/A ratio for predicting AKI of critically ill sepsis patients was superior to that of lactate measurements.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Ko, Dong Ryul(고동률) ORCID logo https://orcid.org/0000-0002-3098-2784
Kong, Tae Young(공태영) ORCID logo https://orcid.org/0000-0002-4182-7245
Kim, Si Nae(김시내)
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Choa, Min Hong(좌민홍) ORCID logo https://orcid.org/0000-0003-0338-994X
Hwang, Yoon Jung(황윤정) ORCID logo https://orcid.org/0000-0001-7286-7699
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170974
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