Effect of Blood Pressure Response Index on Acute Kidney Injury in Elderly Patients with Severe Pneumonia Shock

Background The risk factors leading to acute kidney injury (AKI) in elderly patients with severe pneumonia have not yet been fully clarified. Objective To investigate the association between the blood pressure response index (BPRI) and the incidence of AKI in elderly patients with severe pneumonia-induced shock. Methods A retrospective cohort study was conducted to collect clinical data from patients with severe pneumonia-induced shock admitted to the Second People's Hospital of Changzhou between 2016 and 2024. The clinical data of patients were systematically extracted from the hospital's electronic medical record system. BPRI was calculated as mean arterial pressure divided by the vasoactive-inotropic score. Document the incidence of AKI following hospitalization and the 30-day survival rate. Multivariate Logistic regression analysis was performed to evaluate the risk value of BPRI for AKI development. Receiver operating characteristic (ROC) curves were constructed to assess the predictive accuracy of BPRI for AKI, with the area under the curve (AUC) indicating the strength of prediction. Kaplan-Meier survival curves were used to analyze 30-day mortality among patients stratified by AKI risk, with differences tested using the Log-rank test. Results A total of 237 patients were included in the study, of whom 96 (40.5%) developed AKI. Multivariate Logistic regression analysis revealed that elevated BPRI was a protective factor against AKI development (OR=0.751, 95%CI=0.678-0.831, P