Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis
Background: The relationship between perfusion index (PI) and organ dysfunction in patients in the intensive care unit (ICU) is not clear. This study aimed to explore the relationship between PI and renal function in the perioperative critical care setting and evaluate the predictive efficiency of P...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Journal of Intensive Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667100X23000257 |
| _version_ | 1797774769906515968 |
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| author | Shengjun Liu Longxiang Su Changjing Zhuge Huaiwu He Yun Long |
| author_facet | Shengjun Liu Longxiang Su Changjing Zhuge Huaiwu He Yun Long |
| author_sort | Shengjun Liu |
| collection | DOAJ |
| description | Background: The relationship between perfusion index (PI) and organ dysfunction in patients in the intensive care unit (ICU) is not clear. This study aimed to explore the relationship between PI and renal function in the perioperative critical care setting and evaluate the predictive efficiency of PI on patients with acute kidney injury (AKI) in the ICU. Methods: This retrospective analysis involved 12,979 patients who had undergone an operation and were admitted to the ICU in Peking Union Medical College Hospital from January 2014 to December 2019. The distribution of average PI in the first 24 h after ICU admission and its correlation with AKI was calculated by Cox regression. Receiver operating characteristic (ROC) curves were generated to compare the ability of PI, mean arterial pressure (MAP), creatinine, blood urea nitrogen (BUN), and central venous pressure (CVP) to discriminate AKI in the first 48 h in all perioperative critically ill patients. Results: Average PI in the first 24 h served as an independent protective factor of AKI (Odds ratio [OR]=0.786, 95% confidence interval [CI]: 0.704–0.873, P <0.0001). With a decrease in PI by one unit, the incidence of AKI increased 1.74 times. Among the variables explored for the prediction of AKI (PI, MAP, creatine, BUN, and CVP), PI yielded the highest area under the ROC curve, with a sensitivity of 64.34% and specificity of 70.14%. A cut-off value of PI ≤2.12 could be used to predict AKI according to the Youden index. Moreover, patients in the low PI group (PI ≤2.12) exhibited a marked creatine elevation at 24–48 h with a slower decrease compared with those in the high PI group (PI >2.12). Conclusions: As a local blood flow indicator, the initial 24-h average PI for perioperative critically ill patients can predict AKI during their first 120 h in the ICU. |
| first_indexed | 2024-03-12T22:26:02Z |
| format | Article |
| id | doaj.art-c3ffe51400334532b61a1186bc3182c5 |
| institution | Directory Open Access Journal |
| issn | 2667-100X |
| language | English |
| last_indexed | 2024-03-12T22:26:02Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Intensive Medicine |
| spelling | doaj.art-c3ffe51400334532b61a1186bc3182c52023-07-22T04:52:59ZengElsevierJournal of Intensive Medicine2667-100X2023-07-0133261267Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysisShengjun Liu0Longxiang Su1Changjing Zhuge2Huaiwu He3Yun Long4Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, ChinaDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, ChinaBeijing Institute for Scientific and Engineering Computing, Department of Mathematics, Faculty of Science, Beijing University of Technology, Beijing 100124, ChinaDepartment of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; Corresponding authors: Huaiwu He and Yun Long, Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; Corresponding authors: Huaiwu He and Yun Long, Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.Background: The relationship between perfusion index (PI) and organ dysfunction in patients in the intensive care unit (ICU) is not clear. This study aimed to explore the relationship between PI and renal function in the perioperative critical care setting and evaluate the predictive efficiency of PI on patients with acute kidney injury (AKI) in the ICU. Methods: This retrospective analysis involved 12,979 patients who had undergone an operation and were admitted to the ICU in Peking Union Medical College Hospital from January 2014 to December 2019. The distribution of average PI in the first 24 h after ICU admission and its correlation with AKI was calculated by Cox regression. Receiver operating characteristic (ROC) curves were generated to compare the ability of PI, mean arterial pressure (MAP), creatinine, blood urea nitrogen (BUN), and central venous pressure (CVP) to discriminate AKI in the first 48 h in all perioperative critically ill patients. Results: Average PI in the first 24 h served as an independent protective factor of AKI (Odds ratio [OR]=0.786, 95% confidence interval [CI]: 0.704–0.873, P <0.0001). With a decrease in PI by one unit, the incidence of AKI increased 1.74 times. Among the variables explored for the prediction of AKI (PI, MAP, creatine, BUN, and CVP), PI yielded the highest area under the ROC curve, with a sensitivity of 64.34% and specificity of 70.14%. A cut-off value of PI ≤2.12 could be used to predict AKI according to the Youden index. Moreover, patients in the low PI group (PI ≤2.12) exhibited a marked creatine elevation at 24–48 h with a slower decrease compared with those in the high PI group (PI >2.12). Conclusions: As a local blood flow indicator, the initial 24-h average PI for perioperative critically ill patients can predict AKI during their first 120 h in the ICU.http://www.sciencedirect.com/science/article/pii/S2667100X23000257Perfusion indexAcute kidney injuryPerioperative |
| spellingShingle | Shengjun Liu Longxiang Su Changjing Zhuge Huaiwu He Yun Long Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis Journal of Intensive Medicine Perfusion index Acute kidney injury Perioperative |
| title | Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis |
| title_full | Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis |
| title_fullStr | Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis |
| title_full_unstemmed | Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis |
| title_short | Initial 24-h perfusion index of ICU admission is associated with acute kidney injury in perioperative critically ill patients: A retrospective cohort analysis |
| title_sort | initial 24 h perfusion index of icu admission is associated with acute kidney injury in perioperative critically ill patients a retrospective cohort analysis |
| topic | Perfusion index Acute kidney injury Perioperative |
| url | http://www.sciencedirect.com/science/article/pii/S2667100X23000257 |
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