Scoring systems and outcome of chronic kidney disease patients admitted in intensive care units

The outcome of chronic kidney disease (CKD) patients admitted to the Intensive Care Unit (ICU) is difficult to predict. This study assessed the outcome of CKD patients admitted to the ICU and evaluated prediction of 30-day mortality using the Acute Physiology and Chronic Health Evaluation (APACHE II...

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Bibliographic Details
Published in:Saudi journal of kidney diseases and transplantation 2018-03, Vol.29 (2), p.310-317
Main Authors: Godhani, Umesh, Patel, Mohan, Gumber, Manoj, Kute, Vivek, Goswami, Jitendra, Balwani, Manish R.
Format: Article
Language:English
Subjects:
Age
Chronic kidney failure
Critical care
Failure
Family medical history
Health aspects
Hemodialysis
Hospital patients
Hospitals
Intensive care
Kidney diseases
Mortality
Nephrology
Patient outcomes
Physiological aspects
Physiology
Population
Prognosis
Renal replacement therapy
Risk factors
Sepsis
Transplants & implants
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Summary:The outcome of chronic kidney disease (CKD) patients admitted to the Intensive Care Unit (ICU) is difficult to predict. This study assessed the outcome of CKD patients admitted to the ICU and evaluated prediction of 30-day mortality using the Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), and Sequential Organ Failure Assessment (SOFA) score. One hundred consecutive CKD patients admitted to the ICU at a tertiary care hospital, Ahmedabad between 2011 and 2013 were included prospectively. Data on demographics, indication for admission, cause of CKD, use of vasoactive drugs and mechanical ventilation (MV), mode of renal replacement therapy (RRT), and 30-day mortality were recorded. The APACHE II, SAPS II, and SOFA scores were calculated based on the admission characteristics. The mean APACHE II, SAPS II, and SOFA scores were 28.22 ± 7.53, 43.04 ± 16.40, and 10.39 ± 5.20, respectively, and area under receiver operating characteristics curve in predicting 30-day mortality were 0.961, 0.994, and 0.950, respectively. The scores were significantly higher in 30-day nonsurvivors as compared to survivors (P = 0.001). During the ICU stay, MV and vasoactive drugs were required in 57% and 67% of the patients, respectively, and the requirement was significantly greater in nonsurvivors as compared to survivors (P = 0.001). About 85% of patients were on intermittent hemodialysis and 15% of patients were on continuous veno
ISSN:1319-2442
2320-3838
DOI:10.4103/1319-2442.229268