关键词: 急性肾损伤, 对比剂, 缺血性卒中, 血管造影, 死亡率

Abstract:

Ｏｂｊｅｃｔｉｖｅ：The association between contrastinduced acute kidney injury (CIAKI) and prognosis in cerebrovascular patients is still unknown. This study aimed to determine whether CIAKI is a risk factor for inhospital mortality and 1year mortality in ischemic stroke patients undergoing cerebral angiography.
Ｍｅｔｈｏｄｏｌｏｇｙ：This retrospective observational study consisted of consecutive cerebral ischemic stroke patients undergoing cerebral angiography at Guangdong General Hospital between January 2009 and December 2013. Patient demographics, medical history, physical examination, National Institute of Health Stroke scale (NIHSS) score of neurological deficit, medication use, laboratory findings, procedural characteristics, length of stay in the hospital, requirement for renal replacement therapy (RRT), date of inhospital death, and date of 1year death were collected. Univariate and multivariate logistic regression analyses were used to determine whether CIAKI was an independent risk factor for inhospital mortality. Cox regression was performed to assess the correlation between CIAKI and 1year mortality.
Ｒｅｓｕｌｔｓ：A total of 1 820 ischemic stroke patients undergoing cerebral angiography were analyzed. CIAKI was observed in 81 patients (45%) and was significantly associated with a higher rate of inhospital mortality (136% vs 48%, P<0001) and 1year mortality (370% vs 183%, P<0001). CIAKI didnt increase the length of stay in the hospital (313±164 days vs 302± 160 days,P=0540). After adjusting for potential confounding risk factors, patients with CIAKI had a 4fold higher risk of compared with patients without CIAKI (odds ratio [OR] 399; 95% confidence interval [CI] 143～1114; P=0008). CIAKI also increased 1year hospital mortality independently (hazard ratio [HR] 196, 95%CI 118-326; P=0009).
Ｃｏｎｃｌｕｓｉｏｎ：CIAKI is an independent risk factor for inhospital mortality and 1year mortality in ischemic stroke patients undergoing cerebral angiography.