Background
Methods
Data source and pre-processing
Study population
Clinic variables and definition
Variable | Total (n = 760) | Non-AKI (n = 446) | AKI (n = 314) | P value |
---|---|---|---|---|
Age, years | 46.1 [33.7, 57.4] | 42.7 [29.8, 55.9] | 48.4 [36.7, 60.5] | < 0.001 |
Gender (Female) | 438 (57.6) | 250 (56.1) | 188 (59.9) | 0.330 |
Weight, Kg | 72.7 [63.2, 82.9] | 71.9 [63.5, 81.8] | 74.2 [62.1, 84.9] | 0.205 |
Ethnicity | 0.19 | |||
Caucasian | 429 (56.4) | 252 (56.5) | 177 (56.4) | |
African-American | 228 (30.0) | 125 (28.0) | 103 (32.8) | |
Hispanic-American | 35 (4.6) | 25 (5.6) | 10 (3.2) | |
Other | 68 (8.9) | 44 (9.9) | 24 (7.6) | |
DM type | 0.012 | |||
T1DM | 525 (69.2) | 324 (72.8) | 201 (64.0) | |
T2DM | 234 (30.8) | 121 (27.2) | 113 (36.0) | |
Temperature, °C | 37.3 [37.0, 37.7] | 37.3 [37.0, 37.6] | 37.4 [37.0, 37.7] | 0.010 |
HR, beats/min | 108.0 [97.0, 120.0] | 109.0 [99.0, 120.0] | 107.0 [96.0, 119.0] | 0.190 |
RR, breaths/min | 25.4 [22.0, 29.0] | 25.0 [22.0, 28.0] | 26.0 [23.0, 30.0] | 0.004 |
SBP, mmHg | 98.0 [89.0, 108.0] | 98.0 [90.0, 108.0] | 97.0 [86.0, 108.0] | 0.072 |
DBP, mmHg | 46.0 [39.0, 54.0] | 48.0 [41.0, 55.0] | 44.5 [37.0, 52.0] | < 0.001 |
Microangiopathy | 266 (35.0) | 131 (29.4) | 135 (43.0) | < 0.001 |
Macroangiopathy | 137 (18.0) | 60 (13.5) | 77 (24.5) | < 0.001 |
Preexisting CKD | 93 (12.2) | 38 (8.5) | 55 (17.5) | < 0.001 |
UTI | 92 (12.1) | 43 (9.6) | 49 (15.6) | 0.017 |
Pneumonia | 48 (6.3) | 19 (4.3) | 29 (9.2) | 0.006 |
Liver disease | 60 (7.9) | 30 (6.7) | 30 (9.6) | 0.173 |
History of hypertension | 80 (10.5) | 33 (7.4) | 47 (15.0) | 0.001 |
History of CHF | 65 (8.6) | 22 (4.9) | 43 (13.7) | < 0.001 |
Bicarbonate, mEq/L | 14.0 [9.0, 18.0] | 13.0 [8.0, 18.0] | 15.0 [10.0, 19.0] | < 0.001 |
WBC, K/uL | 13.6 [9.9, 17.7] | 13.3 [9.6, 17.6] | 13.8 [10.5, 18.1] | 0.177 |
Neutrophil granulocyte, % | 83.0 [75.0, 88.3] | 83.0 [75.6, 88.2] | 83.0 [74.3, 88.5] | 0.912 |
Platelets, K/uL | 299.0 [236.0, 377.0] | 299.0 [240.2, 369.8] | 300.5 [232.0, 384.8] | 0.902 |
Hemoglobin, g/dl | 12.8 [11.4, 14.5] | 13.3 [11.8, 14.8] | 12.1 [10.8, 13.6] | < 0.001 |
Sodium, mEq/L | 141.0 [138.0, 144.0] | 140.0 [138.0, 144.0] | 141.0 [138.0, 145.0] | 0.036 |
Chloride, mEq/L | 111.0 [107.0, 115.0] | 111.0 [107.0, 114.0] | 111.0 [107.0, 115.0] | 0.859 |
AG | 21.2 [17.6, 24.7] | 21.4 [17.8, 25.2] | 20.3 [17.2, 24.1] | 0.029 |
Total osmotic pressure | 319.7 [308.7, 334.8] | 318.5 [308.1, 333.5] | 322.0 [310.5, 336.0] | 0.059 |
BUN, mg/dl | 27.0 [17.0, 42.0] | 24.0 [16.0, 37.8] | 34.0 [19.0, 49.0] | < 0.001 |
Potassium, mEq/L | 4.3 [3.8, 4.9] | 4.3 [3.8, 5.0] | 4.2 [3.8, 4.8] | 0.353 |
Blood glucose, mg/dl | 306.0 [164.5, 506.2] | 331.5 [175.5, 525.8] | 265.5 [153.2, 498.5] | 0.044 |
SAPSII | 27.0 [20.0, 36.0] | 24.0 [19.0, 32.0] | 30.0 [23.0, 41.0] | < 0.001 |
OASIS | 25.0 [21.0, 31.0] | 24.0 [21.0, 28.0] | 28.0 [23.0, 34.0] | < 0.001 |
SOFA | 2.0 [1.0, 4.0] | 2.0 [1.0, 3.0] | 3.0 [2.0, 5.0] | < 0.001 |
GCS | 15.0 [14.0, 15.0] | 15.0 [14.0, 15.0] | 15.0 [14.0, 15.0] | < 0.001 |
Infusion volume, ml | 1000.0 [0.0, 2750.5] | 1000.0 [0.0, 2759.0] | 1000.0 [0.0, 2733.8] | 0.717 |
Urine output, ml | 2071.6 [1396.8, 2959.2] | 2200.0 [1543.2, 3217.2] | 1790.0 [1148.5, 2670.0] | < 0.001 |
eGFR | 98.2 [62.2, 123.0] | 103.4 [71.8, 124.2] | 86.0 [45.9, 118.3] | < 0.001 |
Use of NaHCO3 | 72 (9.5) | 25 (5.6) | 47 (15.0) | < 0.001 |
Mechanical ventilation | 91 (12.0) | 18 (4.0) | 73 (23.2) | < 0.001 |
HLOS, days | 4.3 [2.8, 7.4] | 3.5 [2.3, 5.4] | 6.4 [3.9, 10.4] | < 0.001 |
Hospital mortality | 17 (2.2) | 4 (0.9) | 13 (4.1) | 0.005 |
Statistical analysis
Results
Patient characteristics
Characteristics selection and development of a nomogram
Variables | Multivariable analysis base on LASSO regression result | Multivariable logistics model | ||||
---|---|---|---|---|---|---|
β | OR (95%CI) | P value | β | OR (95%CI) | P value | |
GCS | −0.15 | 0.98 (0.97–1.00) | 0.010 | −0.19 | 0.83 (0.73–0.93) | < 0.05 |
Microangiopathy (yes) | 0.75 | 2.11 (1.36–3.29) | < 0.001 | 0.82 | 2.28 (1.49–3.52) | < 0.001 |
DM type (T2DM) | 0.84 | 2.31 (1.45–3.71) | < 0.001 | 0.96 | 2.62 (1.68–4.11) | < 0.001 |
History of CHF (yes) | 0.94 | 2.55 (1.22–5.63) | 0.016 | 1.04 | 2.83 (1.38–6.13) | < 0.05 |
History of hypertension (yes) | 0.61 | 1.84 (0.59–5.86) | 0.015 | 0.91 | 2.48 (1.28–4.96) | < 0.05 |
DBP, mmHg | −0.01 | 0.99 (0.97–1.00) | 0.089 | −0.02 | 0.98 (0.97–1.00) | < 0.05 |
Urine output, ml | 0.00 | 1.00 (1.00–1.00) | < 0.001 | −0.00 | 1.00 (1.00–1.00) | < 0.001 |
RR, breaths/min | 0.05 | 1.05 (1.01–1.08) | 0.008 | 0.05 | 1.05 (1.02–1.09) | < 0.05 |
Temperature, °C | 0.19 | 1.21 (0.89–1.65) | 0.222 | |||
Preexisting-CKD (yes) | 0.20 | 1.22 (0.42–3.66) | 0.718 | |||
Macroangiopathy (yes) | 0.41 | 1.50 (0.90–2.51) | 0.117 | |||
UTI (Yes) | 0.16 | 1.17 (0.65–2.13) | 0.597 | |||
BUN, mg/dl | 0.00 | 1.00 (0.99–1.01) | 0.472 | |||
Bicarbonate, mEq/L | 0.02 | 1.02 (0.99–1.06) | 0.210 |