Observational studyAging clinical and experimental research2022
Missed diagnosis of acute kidney injury in older patients with invasive mechanical ventilation: a multicenter retrospective study.
Observational study in Aging clinical and experimental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.Renal failure · 2026Article
- Clustering analysis of multi-site electronic health records reveals distinct subphenotypes in stage-1 acute kidney injury.Communications medicine · 2025Article
- Unexpectedly high rate of unrecognized acute kidney injury and its trend over the past 14 years.Scientific reports · 2025Article
- Early and minimal changes in serum creatinine can predict prognosis in elderly patients receiving invasive mechanical ventilation: A retrospective observational study.Journal of intensive medicine · 2024Article
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6 authors at 1 institution in 1 country.
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Abstract
objectivesPatients who undergo mechanical ventilation (MV) are at higher risk of suffering from acute kidney injury (AKI). However, whether AKI is diagnosed in all patients and the association between AKI and mortality are unclear.
methodsThis was a retrospective, observational, multicenter cohort study conducted from January 2008 to December 2020 that included 3271 consecutive older patients (≥ 75 years) who received invasive MV from four medical centers in Chinese PLA General Hospital. AKI was diagnosed according to the serum creatinine (Scr)-based Kidney Disease: Improving Global Outcomes guidelines by an absolute increase in Scr of ≥ 26.5 µmol/L within the first 48 h of MV. The outcomes of patients with and without AKI and whether AKI was recognized were compared.
resultsA total of 1292 patients were included in the final evaluation. Three hundred seventy-six patients (29.1%) fulfilled the diagnostic criteria. Among the 376 AKI patients, the recognition rate and nonrecognition rate were 62.8% (236/376) and 37.2% (140/376), respectively. The overall 90-day mortality rate was 45.2% (584/1,292), which was dramatically increased in unrecognized AKI patients and recognized AKI compared to non-AKI patients (70.7% vs. 54.7% vs. 38.9%, respectively, P < 0.001). The survival of patients with recognized AKI was better than that of patients with unrecognized AKI. Multivariate logistic regression analysis revealed that recognized AKI was significantly associated with mean arterial pressure, positive end-expiratory pressure, uric acid, baseline Scr, and peak Scr. AKI was identified as an independent predictor of all-cause 90-day mortality (recognized AKI vs. non-AKI: HR = 1.722; 95% CI = 1.399-2.119; P < 0.001 and unrecognized AKI vs. non-AKI: HR = 2.632; 95% CI = 2.081-3.329; P < 0.001).
conclusionsAKI is a common complication in older patients undergoing MV, with substantial underdiagnosis and undertreatment. Interventions for improving the diagnosis of AKI are urgently needed.
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