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目的了解综合性医院住院患者急性肾损伤(AKI)的发病率、预后,以及接受手术操作对住院时间和预后的影响。方法通过回顾性收集2005年1月1日至2016年6月30日某三甲综合医院住院患者的住院病案资料及检验结果,总结分析患者的临床特征及其转归、接受的手术操作分布等。结果观察期间共有住院患者933 949例,住院患者总死亡率为1.52%;其中2602例患者住院期间发生AKI,发病率为0.28%,死亡率为3.23%。2005年-2010年出院患者362 609人,AKI的发病率为0.30%,死亡率4.28%;2011年-2016年出院患者571 340人,AKI发病率为0.27%,死亡率2.49%。与2005年-2010年组相比,2011年-2016年组的平均年龄相对较高,差异有统计学意义(P<0.05);AKI发病率较低,差异有统计学意义(χ~2=10.979,P<0.05);住院患者主要接受的手术操作为肾穿刺活检、骨髓穿刺术、输尿管镜下钬激光碎石取石术。结论 2005年-2016年住院患者AKI发病率及死亡率呈现下降趋势,平均发病年龄有所升高。患者接受手术操作延长住院天数,降低治疗好转率。
Objective To investigate the incidence and prognosis of acute kidney injury (AKI) in hospitalized patients in general hospitals and the influence of operation on the length of hospital stay and prognosis. Methods By retrospectively collecting the inpatient medical records and test results of inpatients in a Grade I general hospital from January 1, 2005 to June 30, 2016, the clinical characteristics, the outcomes of the patients and the distribution of the accepted surgical operations were summarized and analyzed. Results During the observation period, 933 949 inpatients were hospitalized and the total mortality rate was 1.52%. Among them, 2602 patients were hospitalized with AKI, the incidence was 0.28% and the mortality rate was 3.23%. From 2005 to 2010, there were 362,609 discharged patients. The incidence of AKI was 0.30% and the mortality rate was 4.28%. From 2011 to 2016, 571 340 patients were discharged. The incidence of AKI was 0.27% and the death rate was 2.49%. Compared with the 2005-2010 group, the average age of the group from 2011 to 2016 was relatively high, the difference was statistically significant (P <0.05); the incidence of AKI was lower, the difference was statistically significant (χ ~ 2 = 10.979, P <0.05). The main accepted surgical procedures in hospital were renal biopsy, bone marrow puncture and ureteroscopic holmium laser lithotripsy. Conclusions The incidence and mortality of AKI in hospitalized patients from 2005 to 2016 showed a decreasing trend with an increase in the mean age of onset. Patients underwent surgical procedures to prolong the length of stay and reduce the rate of improvement.