by the persistent method. Background Oliguria is defined as a urine output (UO) of <0.5 ml/kg per hour over 6 hours. There is no consensus as per whether an average or persistent value should be considered. Methods We analyzed all adults admitted to a tertiary intensive care unit between 2010 and 2020, except those on chronic dialysis or who declined consent. We extracted hourly UO and, across 6-hour sliding time windows, assessed for the presence of oliguria according to the average (mean UO below threshold) and persistent (all measurements below a threshold) methods. For both methods, we compared oliguria's incidence and association with 90-day mortality and acute kidney disease at hospital discharge. Results Among 15,253 patients, the average method identified oliguria more often than the persistent method (73% [95% confidence interval, 72.3 to 73.7] versus 54.3% [53.5 to 55.1]). It displayed a higher sensitivity for the prediction of 90-day mortality (85% [83.6 to 86.4] versus 70.3% [68.5 to 72]) and acute kidney disease at hospital discharge (85.6% [84.2 to 87] versus 71.8% [70 to 73.6]). However, its specificity was lower for both outcomes (29.8% [28.9 to 30.6] versus 49.4% [48.5 to 50.3] and 29.8% [29 to 30.7] versus 49.8% [48.9 to 50.7]). After adjusting for illness severity, comorbidities, age, admission year, weight, sex, and AKI on admission, the absolute difference in mortality attributable to oliguria at the population level was similar with both methods (5%). Similar results were obtained when analyses were restricted to patients without AKI on admission, with documented body weight, with presence of indwelling catheter throughout stay, and who did not receive KRT or diuretics. Conclusions The assessment method of oliguria has major diagnostic and prognostic implications. Its definition should be standardized....

中文翻译：

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平均与持续减少尿量来定义危重患者少尿：一项观察性研究


通过持久的方法。背景 少尿定义为 6 小时内每小时尿量 (UO) 为 <0.5 ml/kg。对于是否应考虑平均值或持续值尚未达成共识。方法 我们分析了 2010 年至 2020 年间入住三级重症监护病房的所有成年人，除了那些接受长期透析或拒绝同意的成年人。我们提取每小时的 UO，并在 6 小时的滑动时间窗口中，根据平均值（平均 UO 低于阈值）和持续（所有测量值低于阈值）方法评估少尿的存在。对于这两种方法，我们比较了少尿的发生率以及与 90 天死亡率和出院时急性肾病的关系。结果 在 15,253 名患者中，平均方法比持续方法更容易发现少尿（73% [95% 置信区间，72.3 至 73.7] 对比 54.3% [53.5 至 55.1]）。它对 90 天死亡率（85% [83.6 至 86.4] 对比 70.3% [68.5 至 72]）和出院时急性肾病（85.6% [84.2 至 87] 对比 71.8% [70]至 73.6]）。然而，这两种结果的特异性均较低（29.8% [28.9 - 30.6] vs 49.4% [48.5 - 50.3] 和 29.8% [29 - 30.7] vs 49.8% [48.9 - 50.7]）。调整疾病严重程度、合并症、年龄、入院年份、体重、性别和入院时 AKI 后，两种方法在人群水平上由少尿引起的死亡率的绝对差异相似 (5%)。当分析仅限于入院时未出现 AKI、有体重记录、住院期间留置导尿管且未接受 KRT 或利尿剂的患者时，得到了类似的结果。 结论 少尿的评估方法具有重要的诊断和预后意义。它的定义应该标准化......