最新的研究成果，本论文的主要观点为中文摘要： 目的：急性肾损伤是急诊危重患者常见的并发症且显著影响患者预后，急诊科为该类患者收住的首站，本文探讨急诊科危重患者急性肾损伤的发生率及危险因素。 方法：回顾性队列研究，利用电子病历系统收集2018年9月-12月经由北京协和医院抢救室收治的急诊危重患者，根据患者入院后7天内是否发生AKI，将患者分为AKI+组和AKI-组。收集患者入抢救室时的人口学数据、APACHII评分、是否使用肾脏毒性药物、24h内液体量及院内生存时间等相关数据。使用多因素logistic回归分析方法探讨发生AKI的危险因素。使用COX回归研究AKI的发生对患者住院生存率的影响，并分析AKI严重程度与急诊患者死亡风险的相关性。 结果：最终纳入收住抢救室的急诊危重患者238名，其中108名患者发生AKI（45。4%）发生1级AKI的 患者83例（34。9%），2-3级AKI患者 25例（10。5%）。多因素Logisitc回归提示：较高的APACHE II评分[OR=1。11，95%CI（1。07-1。16）， P＜0。01]，应用血管活性药[OR=2。20，95%CI（1。08-4。49），P=0。03]，糖尿病（OR=2。33，95% CI（1。23-4。42），P=0。01），较高的液体负荷（OR=3。10，95%CI（1。17-8。25），P=0。02）是发生AK的独立危险因素，多因素COX回归校正APACHII评分和年龄后,AKI仍然是急诊患者院内死亡的独立危险因素，且AKI严重程度显著增加急诊患者相关死亡风险[AKI1级HR=1。45,95%CI（1。08-2。03）,p=0。04; AKI2-3级HR=3。15，95% CI（1。49-4。81），p=0。03]。 结论：急诊患者中AKI的发生并非少见，且显著影响患者预。较高的APACHE II评分, 应用血管活性药，基础糖尿病，较高的液体负荷是发生AKI的危险因素。提示早期识别该类患者并给予相应的监测和管理对于改善其预后有重要意义。 英文摘要： Objective: Acute kidney injury is a common complication in emergency department patients。 This article mainly discusses the incidence and risk factors of acute kidney injury in critically ill patients in emergency department。 Methods: A retrospective observational study was used to collect 238 critically ill patients admitted to the rescue room of Peking Union Medical College Hospital from September to December 2018 using an electronic medical record system。 Patients were divided into AKI+ group and AKI- group according to whether AKI occurred within 7 days after admission。Demographic data and post-hospital data were collected。 Clinical data, and the severity of AKI was evaluated according to KDIGO guidelines。 Multivariate regression analysis was used to explore the risk factors for AKI。 Result: Among the 238 critical patients who were finally selected, 108 patients developed AKI, with an incidence rate of 45。4%。 Among them, 83 cases (34。9%) of stage 1 AKI occurred, and 25 cases of stage 2-3 AKI ( 10。5%)。Multi-factor Logisitc regression suggested:High APACHE II score (OR=1。11, 95%CI (1。07-1。16), P < 0。01), application of vasoactive drugs (OR=2。20, 95%CI (1。08-4。49), P=0。03), diabetes mellitus (OR=2。33, 95%CI (1。23-4。42), P=0。01), and high fluid load(OR=3。10, 95%CI (1。17-8。25)。P = 0。02) were risk factors for AKI in the emergency department。Multivariate COX regression adjusted APACHII score and age showed that AKI was an independent risk factor for in-hospital death (HR=3。15, 95%CI (1。49-4。81), P =0。03)。 Conclusions: The incidence of AKI is higher in emergency department patients, which significantly affects the prognosis, higher APACHE II score, the use of vasoactive drugs, basic diabetes and high fluid load were risk factors for AKI, and placement of urinals is associated with AKI。 Therefore, early identification of relevant risk factors and timely intervention can effectively improve the prognosis。不知是否符合录用要求，望您批评与指正。