Impact of Acute Kidney Injury Classification on ICU Outcomes
Author Information
Author(s): Marlies Ostermann, Rene Chang
Primary Institution: Guy's & St Thomas' Foundation Hospital
Hypothesis
The study aims to evaluate the impact of the Acute Kidney Injury (AKI) classification on patient outcomes in intensive care units (ICUs).
Conclusion
The proposed AKI classification correlated with ICU outcomes, but only AKI III was an independent risk factor for ICU mortality.
Supporting Evidence
- 35.4% of patients fulfilled the criteria for AKI.
- ICU mortality was 10.7% in patients with no AKI and 49.6% in AKI III.
- AKI III was independently associated with ICU mortality with an odds ratio of 2.27.
- Patients with AKI had higher APACHE II and SOFA scores compared to those without AKI.
- Mechanical ventilation was required for 86.8% of patients with AKI III.
Takeaway
This study looked at how kidney problems in sick patients affect their chances of survival in the hospital. It found that the worst kidney problems are linked to higher death rates.
Methodology
The study analyzed data from the Riyadh Intensive Care Program database, applying AKI classification criteria to 22,303 adult patients admitted to ICUs in the UK and Germany.
Potential Biases
The use of renal replacement therapy as a criterion for AKI III may introduce subjectivity and confounding effects.
Limitations
The study is retrospective and may have underestimated the incidence of AKI due to exclusion criteria and lack of pre-admission data.
Participant Demographics
Adult patients admitted to ICUs in the UK and Germany between 1989 and 1999.
Statistical Information
P-Value
p<0.0001
Confidence Interval
95% CI for odds ratios provided in the study.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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