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March 6, 2026SHILAP Revista de lepidopterologíaOpen Access

Short-term outcome and prognostic factors in acute fulminant myocarditis with acute kidney injury patients

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Why the study?

To evaluate the impact of the systemic inflammatory response index and other clinical features on short-term outcome in patients with acute fulminant myocarditis complicated by acute kidney injury.

Population

118 patients with acute fulminant myocarditis and acute kidney injury

Comparison

Survival group vs death group based on 30-day mortality

Design

Retrospective cohort study

Follow-up

30 days

Key result

Reduced 24-h urine volume and lower ejection fraction independently predicted higher 30-day mortality in patients with acute fulminant myocarditis and acute kidney injury, with AUCs of 0.819 and 0.740 respectively.

Authors

MZMengyuan ZhuZYZhenzhen YouLWLijiao Wang

Discussion

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Overview

May aid risk stratification for intensified care; hypothesis-generating for integrating urine volume and LVEF into prognostic models.

Key Points

  • This study aims to evaluate the influence of SIRI and clinical features on short-term outcomes in patients with AFM and AKI.
  • Retrospective analysis of patients diagnosed with AFM and AKI.
  • Division of patients into survival and death groups based on 30-day mortality.
  • Comparison of demographic data, vital signs, and laboratory parameters between groups.
  • Multivariate logistic regression to identify independent predictors of 30-day mortality.
  • ROC curve analysis for assessing the predictive value of identified factors.
  • 44 patients in the death group showed higher rates of respiratory failure and utilized more intensive treatments.
  • Patients in the death group had elevated proteinuria and inflammatory markers compared to survivors.
  • 24-hour urine volume and ejection fraction were identified as significant independent predictors of mortality.
  • ROC analysis indicated good predictive values for urine volume (AUC 0.819) and ejection fraction (AUC 0.740).

Study Design

Type

Observational (n=118)

Multicenter

No

Structured PICO

P
Population
118 patients diagnosed with acute fulminant myocarditis (AFM) and acute kidney injury (AKI), median age 41 years, 52.5% male, treated at a single center in China.
O
Outcome
30-day mortalityhard clinical

Main Result

Absolute Event Rate: 37.3% vs 62.7%

In patients with acute fulminant myocarditis and acute kidney injury, reduced 24-hour urine volume and lower ejection fraction are independent predictors of 30-day mortality.

Limitations

  • Retrospective observational design
  • Small sample size
  • Lack of myocardial biopsy for pathological confirmation
  • SIRI not independent predictor despite association with mortality
  • No long-term prognosis data available
  • Retrospective design
  • Absence of myocardial biopsy limited pathological confirmation
  • SIRI did not remain an independent predictor
  • Focused on 30-day mortality while lacking long-term prognosis assessment

Cite This Study

Zhu et al. (2026) conducted an observational in Patients with acute fulminant myocarditis complicated by acute kidney injury (n=118). Reduced 24-h urine volume and lower ejection fraction independently predicted higher 30-day mortality in patients with acute fulminant myocarditis and acute kidney injury, with AUCs of 0.819 and 0.740 respectively.

synapsesocial.com/papers/69aa6f0d531e4c4a9ff59305https://doi.org/10.3389/fmed.2026.1713936
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