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Objective To investigate the influence of serum creatinine (sCr) at different time-points on prognosis of critically ill patients with acute kidney injury (AKI).Methods This study was retrospectively analyzed the clinical data of critical patients with AKI who admitted to the mixed ICU of Xiaolan Hospital of Southern Medical University during March 2015 and January 2016. According to the clinical prognosis, the patients were divided into the renal replacement therapy (RRT) group and non-renal replacement therapy (non-RRT) group, 28-day renal loss group and renal recover group, hospital death group and survival group. Serum Cr at different time-points and clinical data were collected. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were used to evaluate the capability of sCr at different time-points in predicting clinical prognosis.Results During the study, 85 AKI patients were enrolled. The in-hospital mortality was 20％, RRT rate was 15.3％, and renal lose at 28 days after ICU admission was 31.8％. The levels of sCr out of ICU (o-sCr) and the peak of sCr were significantly higher in the RRT group than the non-RRT group (P<0.01). The o-sCr and p-sCr predicted RRT during the hospital stay with a higher AUC value (0.806vs 0.833) than b-sCr and a-sCr. The levels of b-sCr, a-sCr, o-sCr, and p-sCr were all significantly higher in the28-day renal loss group than the kidney recover group (P<0.01). The levels of o-sCr and p-sCr were significantly higher in the hospital death group than the survival group (P<0.05). The o-sCr predicted renal lose at 28 days and hospital death with the highest AUC value of 0.850 and 0.797, respectively.Conclusions It cannot be ignored to monitor dynamically the level of sCr at different time-points in critical patients with AKI, which can predict the clinical prognosis such as hospital death, RRT and renal lose at 28 days after ICU admission.
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Objective@#To investigate the influence of serum creatinine (sCr) at different time-points on prognosis of critically ill patients with acute kidney injury (AKI).@*Methods@#This study was retrospectively analyzed the clinical data of critical patients with AKI who admitted to the mixed ICU of Xiaolan Hospital of Southern Medical University during March 2015 and January 2016. According to the clinical prognosis, the patients were divided into the renal replacement therapy (RRT) group and non-renal replacement therapy (non-RRT) group, 28-day renal loss group and renal recover group, hospital death group and survival group. Serum Cr at different time-points and clinical data were collected. The receiver operating characteristic (ROC) curve and the area under curve (AUC) were used to evaluate the capability of sCr at different time-points in predicting clinical prognosis.@*Results@#During the study, 85 AKI patients were enrolled. The in-hospital mortality was 20%, RRT rate was 15.3%, and renal lose at 28 days after ICU admission was 31.8%. The levels of sCr out of ICU (o-sCr) and the peak of sCr were significantly higher in the RRT group than the non-RRT group (P<0.01). The o-sCr and p-sCr predicted RRT during the hospital stay with a higher AUC value (0.806 vs 0.833) than b-sCr and a-sCr. The levels of b-sCr, a-sCr, o-sCr, and p-sCr were all significantly higher in the28-day renal loss group than the kidney recover group (P<0.01). The levels of o-sCr and p-sCr were significantly higher in the hospital death group than the survival group (P<0.05). The o-sCr predicted renal lose at 28 days and hospital death with the highest AUC value of 0.850 and 0.797, respectively.@*Conclusions@#It cannot be ignored to monitor dynamically the level of sCr at different time-points in critical patients with AKI, which can predict the clinical prognosis such as hospital death, RRT and renal lose at 28 days after ICU admission.
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Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.
