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응급 환자에서 조영증강 컴퓨터단층촬영 시행 후 신손상 발생의 예측 인자

Other Titles
 Risk factors to predict post-contrast acute kidney injury after contrast-enhanced computed tomography in the emergency department 
 최소연  ;  유지나  ;  공태영  ;  좌민홍  ;  정현수  ;  정성필 
 Journal of the Korean Society of Emergency Medicine(대한응급의학회지), Vol.32(3) : 231-241, 2021-06 
Journal Title
Journal of the Korean Society of Emergency Medicine(대한응급의학회지)
Issue Date
Contrast media ; Acute kidney injury ; Computed tomography ; Emergency departmen
Objective: This study aimed to investigate the risk factors of post-contrast acute kidney injury (PAKI) and the usefulness of the Mehran score for predicting PAKI in patients who underwent contrast-enhanced abdominopelvic computed tomog raphy (CE-APCT) in the emergency department (ED).
Methods: This was a retrospective observational study. Patients who underwent CE-APCT and had a follow-up creati nine test within 72 hours in the period January to June, 2017, were enrolled for the study. PAKI is defined as a 25% or higher increase in the level of serum creatinine (sCr) within 72 hours after receiving contrast, or an increase in the level of sCr by 0.5 mg/dL. The odds ratio (OR) of risk factors and incidence of PAKI after CE-APCT were analyzed according to the Mehran risk group, and compared to expected incidence. Univariate and multivariate logistic regression analyses were performed for each risk factor.
Results: A total of 1,718 patients were enrolled in the study. Of these, 203 patients (11.8%) developed PAKI, and 2 patients (0.1%) required dialysis. Hypotension (systolic blood pressure <80 mmHg) was determined to be statistically sig nificant (P=0.029; OR, 3.181) among the considered risk factors of PAKI. In the group having abnormal estimated glomerular filtration rate (<90 mL/min/1.73 m2), the age and rate of the underlying disease (congestive heart failure, hypertension) was found to be higher in the PAKI group. The receiver operating curve of Mehran score (area under the curve: 0.521 in model A, 0.520 in model B) was statistically not significant in the univariate analysis. A higher Mehran score was associated with a higher proportion of patients who underwent prophylactic treatment.
Conclusion: There are no definite useful risk factors, including the Mehran score, for predicting PAKI in patients who underwent contrast-enhanced computed tomography in the ED
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kong, Tae Young(공태영) ORCID logo https://orcid.org/0000-0002-4182-7245
Yu, Gina(유지나)
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
Choa, Min Hong(좌민홍) ORCID logo https://orcid.org/0000-0003-0338-994X
Choi, So Yeon(최소연)
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