Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Demographic and Clinical Characteristics of Patients
3.2. Renal Replacement Therapy
3.3. Outcomes of Severe AKI
3.4. Mortality According Cause of AKI
3.5. Number of Affected Organs and Mortality
3.6. Other Characteristics and Mortality
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics of Patients | Units | Value |
---|---|---|
Gender: men/women | n (%) | 375 (65.4)/198 (34.6) |
Age | median(25–75%), years | 69 (56–77) |
Length of hospitalization | median (25–75%), days | 17 (7–36) |
Length of hospitalization till getting into ICU | median (25–75%), days | 6 (2–14) |
Length of hospitalization in ICU till the beginning of RRT | median (25–75%), days | 2 (1–6) |
CKD (the 2nd–5th CKD stage) | n (%) | 171 (29.8) |
CKD (the 1st CKD stage) | n (%) | 23 (4.0) |
Administration of vasopressors | n (%) | 275 (48) |
Application of APV | n (%) | 310 (54.1) |
Sepsis without a septic shock | n (%) | 48 (8.4) |
Sepsis with a septic shock | n (%) | 160 (27.9) |
At the time of the initiation of RRT: | ||
Pulmonary oedema | n (%) | 166 (29.0) |
Systolic BP | mean ± SD, mmHg | 120.4 ± 28.9 |
Diastolic BP | mean ± SD, mmHg | 66 ± 16.6 |
SOFA score | mean ± SD | 8.4 ± 3.9 |
pH | mean ± SD | 7.3 ± 0.1 |
Bicarbonate (HCO3) | mean ± SD, mmol/L | 15.4 ± 5.5 |
RRT duration | median (25–75%), days | 4 (2–14) |
RRT duration | median (25–75%), hours | 16 (6–42) |
Characteristics of Patients | Survivors (n = 277) | Non-Survivors (n = 296) | p Value |
---|---|---|---|
Gender, n (%): men/women | 180 (48)/ 97 (49) | 195 (52)/ 101 (51) | 0.137/ 0.344 |
Age (mean ± SD), years | 64.5 ± 15.9 | 66.3 ± 15.5 | 0.153 |
Length of hospitalization till getting into ICU (mean ± SD), days | 12.4 ± 17.1 | 9.5 ± 12.6 | 0.165 |
Length of stay in ICU till the beginning of RRT (mean ± SD), days | 4.5 ± 5.2 | 4.9 ± 7.5 | 0.697 |
CKD (the 2nd–5th CKD stage), n (%) | 102 (36.8) | 69 (23.3) | 0.006 |
CKD (the 1st CKD stage), n (%) | 10 (3.6) | 13 (4.4) | 0.317 |
Administration of vasopressors, n (%) | 46 (16.6) | 229 (77.4) | <0.001 |
Administration of aminoglycosides, n (%) | 18 (6.8) | 42 (15) | 0.002 |
Sepsis n (%) | 65 (23.5) | 143 (48.3) | <0.001 |
At the time of the initiation of RRT: | |||
Pulmonary oedema, n (%) | 60 (21.7) | 106 (35.8) | <0.001 |
Oliguria, n (%) | 139 (50.9) | 229 (78.4) | <0.001 |
APV, n (%) | 53 (19.3) | 191 (65) | <0.001 |
Systolic BP (mean ± SD), mmHg | 134.6 ± 27.9 | 107 ± 22.9 | <0.001 |
Diastolic BP (mean ± SD), mmHg | 73.5 ± 14.7 | 58.8 ± 15.2 | <0.001 |
SOFA score (mean ± SD) | 6.1 ± 2.5 | 10.5 ± 3.9 | <0.001 |
pH (mean ± SD) | 7.3 ± 0.1 | 7.6 ± 0.1 | 0.027 |
Factors | OR of Mortality (95% CI) |
---|---|
Age ≥ 65 years | 1.722 (1.08–2.746) |
Systolic BP ≤ 120 mmHg | 3.336 (2.073–5.368) |
Oliguria | 2.226 (1.373–3.608) |
Multiple organ dysfunction syndrome (≥3-organ dysfunction) | 6.26 (3.18–12.322) |
Administration of vasopressors | 2.354 (1.186–4.669) |
Factors | OR of Mortality (95% CI) |
---|---|
Renal AKI cause | 1.679 (1.047–2.694) |
AKI after cardiac surgery | 3.640 (1.453–9.118) |
pH < 7.3 | 1.812 (1.146–2.866) |
Administration of aminoglycosides | 2.447 (1.149–5.209) |
Oliguria | 4.263 (2.586–7.028) |
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Paškevičius, Ž.; Skarupskienė, I.; Balčiuvienė, V.; Dalinkevičienė, E.; Kušleikaitė-Pere, N.; Petrulienė, K.; Žiginskienė, E. Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy. Medicina 2021, 57, 1076. https://doi.org/10.3390/medicina57101076
Paškevičius Ž, Skarupskienė I, Balčiuvienė V, Dalinkevičienė E, Kušleikaitė-Pere N, Petrulienė K, Žiginskienė E. Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy. Medicina. 2021; 57(10):1076. https://doi.org/10.3390/medicina57101076
Chicago/Turabian StylePaškevičius, Žilvinas, Inga Skarupskienė, Vilma Balčiuvienė, Eglė Dalinkevičienė, Neda Kušleikaitė-Pere, Kristina Petrulienė, and Edita Žiginskienė. 2021. "Mortality Prediction in Patients with Severe Acute Kidney Injury Requiring Renal Replacement Therapy" Medicina 57, no. 10: 1076. https://doi.org/10.3390/medicina57101076