详情页 - 首都医科大学宣武医院知识库

当前位置：首页 > 详情页

Dose-response association between fluid overload and in-hospital mortality in critically ill patients: a multicentre, prospective, observational cohort study.

57| 认领 | 导出 | 链接全文 |

文献详情

资源类型：

WOS体系：

Pubmed体系：

收录情况： ◇ SCIE

作者：

机构： [1]Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China [2]Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, China [3]Department of Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China [4]Department of General Practice, Beitaipingzhuang Community Health Service Centre, Beijing, China [5]Medical Intensive Care Unit, Peking Union Medical College Hospital, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China

出处：

DOI：

ISSN：

摘要：

Fluid management is important in ensuring haemodynamic stability in critically ill patients, but can easily lead to fluid overload (FO). However, the optimal fluid balance plot or range for critically ill patients is unknown. This study aimed to explore the dose-response relationship between FO and in-hospital mortality in critically ill patients. Multicentre, prospective, observational study. Eighteen intensive care units (ICUs) of 16 tertiary hospitals in China. Critically ill patients in the ICU for more than 3 days. FO was defined as the ratio of the cumulative fluid balance (L) and initial body weight (kg) on ICU admission, expressed as a percentage. Maximum FO was defined as the peak value of FO during the first 3 days of ICU admission. Logistic regression models with restricted cubic splines were used to explore the pattern and magnitude of the association between maximum FO and risk of in-hospital mortality. Age, sex, Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score on admission, main diagnosis on admission to ICU, comorbidities, time of maximum FO, mechanical ventilation, renal replacement therapy, use of vasopressors and centres were adjusted in multivariable analysis. A total of 3850 patients were included in the study, 929 (24.1%) of whom died in the hospital. For each 1% L/kg increase in maximum FO, the risk of in-hospital mortality increased by 4% (adjusted HR (aHR) 1.04, 95% CI 1.03 to 1.05, p<0.001). A maximum FO greater than 10% was associated with a 44% increased HR of in-hospital mortality compared with an FO less than 5% (aHR 1.44, 95% CI 1.27 to 1.67). Notably, we found a non-linear dose-response association between maximum FO and in-hospital mortality. Both higher and negative fluid balance levels were associated with an increased risk of in-hospital mortality in critically ill patients. ChiCTR-ECH-13003934. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

基金：

语种：

被引次数：

WOS：

PubmedID：

中科院(CAS)分区：

出版当年[2019]版：

大类 | 3 区医学

小类 | 3 区医学：内科

最新[2023]版：

大类 | 3 区医学

小类 | 3 区医学：内科

JCR分区：

出版当年[2018]版：

Q2 MEDICINE, GENERAL & INTERNAL

最新[2023]版：

Q1 MEDICINE, GENERAL & INTERNAL

影响因子： 2.4 最新[2023版] 2.7 最新五年平均 2.376 出版当年[2018版] 2.863 出版当年五年平均 2.413 出版前一年[2017版] 2.496 出版后一年[2019版]

第一作者：

第一作者机构： [1]Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China [2]Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, China

通讯作者：

推荐引用方式(GB/T 7714)：

APA：

MLA：