摘要
Abstract
Objective:To investigate the influencing factors and their predictive value of acute kidney injury(AKI)in patients with sepsis.Method:Eighty patients with sepsis admitted to the Department of Critical Care Medicine of Chaozhou Central Hospital from June 2024 to September 2025 were selected.Based on whether AKI occurred,patients were divided into a non-AKI group(n=49)and an AKI group(n=31).Baseline data,vital signs,sequential organ failure assessment(SOFA)score within 24 hours of ICU admission,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,venous excess ultrasound score(VExUS),fluid balance were compared between the two groups.Multivariate logistic regression was used to analyze the independent risk factors of AKI in sepsis patients,and ROC curve was used to evaluate the predictive efficacy of influencing factors for AKI in sepsis patients.Result:The SOFA score,central venous pressure(CVP),cumulative fluid balance volume on the first day and VExUS in the AKI group were higher than those in the non-AKI group(P<0.05).Multivariate logistic regression analysis showed that elevated VExUS(OR=48.364),SOFA score(OR=3.134),CVP(OR=3.203),and cumulative fluid balance on the first day(OR=1.003)were independent risk factors for the occurrence of AKI(P<0.05).ROC curve analysis revealed that among all single indicators,the VExUS had the highest predictive efficacy for AKI,with an AUC of 0.847[95%CI(0.766,0.929)],a sensitivity of 93.5%,and a specificity of 77.6%.The combined prediction model using these four factors performed better than any single indicator,with an AUC of 0.941[95%CI(0.890,0.992)],a sensitivity of 96.8%,and a specificity of 87.8%.Conclusion:High VExUS,high SOFA score,high CVP,and high cumulative fluid balance volume on the first day are independent risk factor for AKI in patients with sepsis and can serve as an auxiliary ultrasonic indicator for predicting AKI.The combination of these four factors significantly improves predictive performance,providing important reference for early identification of high-risk AKI patients and personalized fluid management in sepsis.关键词
脓毒症/急性肾损伤/静脉淤血超声评分/中心静脉压/液体平衡Key words
Sepsis/Acute kidney injury/Venous excess ultrasound score/Central venous pressure/Fluid balance
