# Characteristics and prognosis of patients with pathogenic microorganism-positive sepsis AKI from ICU: a retrospective cohort study

## TL;DR

This study examines the prognosis and risk factors for patients with sepsis-associated acute kidney injury caused by pathogenic microorganisms in ICU settings.

## Contribution

Identifies key clinical indicators that predict mortality in sepsis-associated AKI patients with confirmed pathogens.

## Key findings

- Hospital mortality rate was 18.96% in patients with pathogenic microorganism-positive sepsis-associated AKI.
- Vasoactive drug use, high lactate levels, and SAPS III scores are significant independent risk factors for in-hospital mortality.
- Lactate levels correlate positively with SAPS II, SAPS III, and LODS scores in these patients.

## Abstract

Sepsis-associated acute kidney injury (SA-AKI) carries a disproportionately high morbidity and mortality rate. While the synergism between dysregulated host response and renal vulnerability is increasingly recognized, the multifactorial drivers of poor prognosis remain poorly defined. The purpose of this study was to investigate the prognosis and clinical characteristics of patients with pathogenic microorganism-positive SA-AKI.

Using a retrospective analysis approach, we extracted populations from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database that fulfilled the diagnostic criteria for confirmed sepsis with microbiological evidence of pathogenic organisms, and patients were divided into two cohorts according to with or without AKI. The severity of the disease in the two groups was collected for evaluation, and the clinical indicators and prognostic results of the patients were evaluated. The objective of this study was to explore the risk factors affecting the prognosis of patients with pathogenic microorganism-positive SA-AKI.

The hospital mortality rate of AKI in patients with pathogenic microbial-positive sepsis was 18.96%. Further analysis showed that the use of vasoactive drug therapy, high lactate level, SAPS II score, SAPS III score, LODS score, and clinical indicators of prolonged hospital stay were independent risk factors for in-hospital mortality in patients with pathogenic microorganism-positive SA-AKI. Among them, SAPS III score plays an important role in predicting the prognosis of sepsis patients with AKI. Further studies found that lactate level was positively correlated with SAPS II score, SAPS III score, and LODS score.

The use of vasoactive drug therapy, high lactate level, SAPS II score, SAPS III score, and LODS score plays an important role in assessing the prognosis of patients with pathogenic microorganism-positive SA-AKI, and multivariate comprehensive assessment is significant in predicting the prognosis of sepsis AKI patients.