Analysis of risk factors for severe acute kidney injury in patients with acute myocardial infarction: A retrospective study

Association between lactate-albumin ratio and 28-day mortality in patients with sepsis-associated acute kidney injury: a retrospective cohort study

The aim of this study was to investigate the correlation between lactate-albumin ratio (LAR) and 28-day mortality in patients with sepsis combined with acute kidney failure (SA-AKI). The study was based on the eICU database and collected data from 1855 patients with SA-AKI. The relationship between LAR and 28-day in-hospital mortality was assessed using multivariate Cox regression models and Kaplan-Meier survival analysis. A generalised summation model was also used to analyse the non-linear relationship between LAR and mortality. The results showed that the 28-day in-hospital mortality rate of the patients was 19.46% (361/1,855), with a significant positive correlation between LAR and mortality (HR: 1.26, 95% CI: 1.18-1.35, p < 0.001). The Kaplan-Meier survival curve showed that the highest quartile of LAR (Q4) had the lowest survival rate. Non-linear analysis showed that when the LAR ratio was less than 2.1, mortality increased with each 1-unit increase in the LAR ratio, with an adjusted hazard ratio of 1.48 (95% CI 1.20, 1.84, p < 0.001). For patients with SA-AKI, a nonlinear relationship between LAR and 28-day risk of death was observed, with higher LAR associated with higher risk of mortality.

Association between serum calcium level and the risk of acute kidney injury in patients with acute myocardial infarction: evidences from the MIMIC-IV database

OBJECTIVE

This cohort study was to assess the association between serum calcium levels and the risk of acute kidney injury (AKI) in acute myocardial infarction (AMI) patients.

METHODS

This study was analyzed using data of 1286 AMI patients aged ≥18 years who stayed in ICU more than 24 h in Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Univariable logistic regression model was established to identify potential covariates. Univariate and multivariable logistic regression models were used to analyze the association between serum calcium and the risk of AKI in patients with AMI. The association between serum calcium and the risk of AKI in patients with AMI was also shown by restricted cubic spline (RCS) plot. Odds ratio (OR) and 95% confidence interval (CI) were calculated.

RESULTS

The median follow-up time was 1.61 (1.23, 2.30) days, and 436 (33.90%) participants had AKI at the end of follow-up. After adjusting for covariates, elevated level of serum calcium level was related to reduced risk of AKI in AMI patients (OR = 0.88, 95%CI: 0.80-0.98). Decreased risk of AKI was found in AMI patients with serum calcium level of 8.40-8.90 mg/dL (OR = 0.54, 95%CI: 0.34-0.86) or ≥8.90 mg/dL (OR = 0.60, 95%CI: 0.37-0.99). The RCS plot depicted that serum calcium level was negatively correlated with the risk of AKI in patients with AMI.

CONCLUSIONS

AMI patients with AKI had lower serum calcium levels compared with those without AKI. Increased serum calcium level was associated with decreased risk of AKI in patients with AMI.

Impact of severe acute kidney injury on short-term mortality in urosepsis

PURPOSE

To evaluate the impact of severe acute kidney injury (AKI) on short-term mortality in patients with urosepsis.

METHODS

This prospective cohort study evaluated 207 patients with urosepsis. AKI was diagnosed in accordance with the Kidney Disease Improving Global Outcomes criteria, and severe AKI was defined as stage 2 or 3 AKI. Patients were divided into two groups: patients who developed severe AKI (severe AKI group) and patients who did not (control group). The primary endpoint was all-cause mortality within 30 days. The secondary endpoints were 90-day mortality and in-hospital mortality. The exploratory outcomes were the risk factors for severe AKI development.

RESULTS

The median patient age was 79 years. Of the 207 patients, 56 (27%) developed severe AKI. The 30-day mortality rate in the severe AKI group was significantly higher than that in the control group (20% vs. 2.0%, respectively; P < 0.001). In the multivariable analysis, performance status and severe AKI were significantly associated with 30-day mortality. The in-hospital mortality and 90-day mortality rates in the severe AKI group were significantly higher than those in the control group (P < 0.001 and P < 0.001, respectively). In the multivariable analysis, age, urolithiasis-related sepsis, lactate values, and disseminated intravascular coagulation were significantly associated with severe AKI development.

CONCLUSIONS

Severe AKI was a common complication in patients with urosepsis and contributed to high short-term mortality rates.

The leading global health challenges in the artificial intelligence era

Millions of people's health is at risk because of several factors and multiple overlapping crises, all of which hit the vulnerable the most. These challenges are dynamic and evolve in response to emerging health challenges and concerns, which need effective collaboration among countries working toward achieving Sustainable Development Goals (SDGs) and securing global health. Mental Health, the Impact of climate change, cardiovascular diseases (CVDs), diabetes, Infectious diseases, health system, and population aging are examples of challenges known to pose a vast burden worldwide. We are at a point known as the "digital revolution," characterized by the expansion of artificial intelligence (AI) and a fusion of technology types. AI has emerged as a powerful tool for addressing various health challenges, and the last ten years have been influential due to the rapid expansion in the production and accessibility of health-related data. The computational models and algorithms can understand complicated health and medical data to perform various functions and deep-learning strategies. This narrative mini-review summarizes the most current AI applications to address the leading global health challenges. Harnessing its capabilities can ultimately mitigate the Impact of these challenges and revolutionize the field. It has the ability to strengthen global health through personalized health care and improved preparedness and response to future challenges. However, ethical and legal concerns about individual or community privacy and autonomy must be addressed for effective implementation.