机构:[1]Global Health – Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden[2]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China大德路总院肾内科大德路总院肾内科广东省中医院[3]Institute of chronic non-communicable disease, Center for Disease Control and Prevention of Guangdong Province, China[4]Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden[5]Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden[6]Key Unit of Methodology in Clinical Research (KUMCR), Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China广东省中医院[7]Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia[8]Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia[9]Translational Research Institute, Brisbane, Australia
Background: Infection is one of the main reasons for hospitalization worldwide, and is associated with an increased risk of cardiovascular mortality. It is unclear whether this association is modified by the presence of reduced renal function. The aim of this study was to analyze the relationship between estimated glomerular filtration rate (eGFR) and cardiovascular mortality in patients hospitalized with infection. Methods: This cohort study included all adult, incident patients who were hospitalized at one of four hospitals in China between 2012 and 2015, had a discharge diagnosis of infection, and had a serum creatinine measurement at admission. Patients receiving renal replacement therapy were excluded. Hospital data were linked to death registry data. All-cause and cardiovascular mortality were evaluated according to admission eGFR [>= 60 (reference), 30-59 and < 30 mL/min/1.73m(2)] using multivariable Cox regression and competing risk analyses. Results: During a median follow-up period of 2.39 years, 40,524 patients were hospitalized with infection (mean age 61 years, 54.3% female 18.4% diabetic). Of these, 4781 died. Lower admission eGFR was associated with progressively increased risks of cardiovascular mortality (>= 60 mL/min/1.73m(2) reference; 30-59 mL/min/1.73m(2) subdistribution hazard ratio [SHR] 2.15, 95% CI 1.85-2.50, P < .01; < 30 mL/min/1.73m(2) SHR 3.19, 95% CI 2.68-3.80, P < .01). The proportion of deaths due to cardiovascular disease increased as the eGFR decreased, predominantly due to ischemic heart disease. Conclusions: Patients hospitalized with infections and reduced renal function have significantly increased risks of cardiovascular mortality. Heart status should be carefully monitored following infections, especially for those with reduced renal function.
基金:
Ministry of Science and Technology [2013BAI02B04]; State Administration of Traditional Chinese Medicine, the People's Republic of China [201407001-1A, 201007005]; Guangzhou science and technology project [2016201604030085]; Guangdong Provincial Hospital of Chinese Medicine, China; Department of Public Health Sciences, Karolinska Institutet, Sweden; Foreign Experts Project, Foreign Experts Bureau of Guangdong Province, China [GDT20164400034]; Guangdong Provincial Hospital of Chinese Medicine [2014KT1305]; Medical Scientific Research Funds of Guangdong Province, China [A2013073]; China scholarship councilChina Scholarship Council [201508440214]; Australian National Health and Medical Research CouncilNational Health and Medical Research Council of Australia; Stockholm County CouncilStockholm County Council; Westman Foundation; Swedish Heart and Lung AssociationSwedish Heart-Lung Foundation; Baxter Healthcare Corporation; Martin Rind Foundation
第一作者机构:[1]Global Health – Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden[2]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou city, Guangdong Province, China
通讯作者:
推荐引用方式(GB/T 7714):
Su Guobin,Xu Yanjun,Xu Xiaojun,et al.Association between reduced renal function and cardiovascular mortality in patients hospitalized with infection: A multi-center cohort study[J].EUROPEAN JOURNAL OF INTERNAL MEDICINE.2018,57:32-38.doi:10.1016/j.ejim.2018.06.017.
APA:
Su, Guobin,Xu, Yanjun,Xu, Xiaojun,Xu, Hong,Lu, Liming...&Lundborg, Cecilia Stalsby.(2018).Association between reduced renal function and cardiovascular mortality in patients hospitalized with infection: A multi-center cohort study.EUROPEAN JOURNAL OF INTERNAL MEDICINE,57,
MLA:
Su, Guobin,et al."Association between reduced renal function and cardiovascular mortality in patients hospitalized with infection: A multi-center cohort study".EUROPEAN JOURNAL OF INTERNAL MEDICINE 57.(2018):32-38