Prevalence, Outcomes and Risk factors of Acute Kidney Injury in Surgical Intensive Care Unit: A Multi-Center Thai University-Based Surgical Intensive Care Units Study (THAI-SICU Study).

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Abstrakt

Tytuł:: Prevalence, Outcomes and Risk factors of Acute Kidney Injury in Surgical Intensive Care Unit: A Multi-Center Thai University-Based Surgical Intensive Care Units Study (THAI-SICU Study).
Autorzy:: Pisitsak C
Chittawatanarat K
Wacharasint P
Chaiwat O
Komonhirun R
Morakul S
Źródło:: Journal of the Medical Association of Thailand = Chotmaihet thangphaet [J Med Assoc Thai] 2016 Sep; Vol. 99 Suppl 6, pp. S193-S200.
Typ publikacji:: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: Bangkok : Medical Association Of Thailand
MeSH Terms:: Intensive Care Units*
Acute Kidney Injury/*epidemiology
APACHE ; Adult ; Aged ; Female ; Hospitals, University ; Humans ; Male ; Middle Aged ; Multiple Organ Failure/epidemiology ; Postoperative Care ; Prevalence ; Prospective Studies ; Risk Factors ; Serum Albumin ; Thailand/epidemiology
Substance Nomenclature:: 0 (Serum Albumin)
Entry Date(s):: Date Created: 20180616 Date Completed: 20180712 Latest Revision: 20181202
Update Code:: 20240105
PMID:: 29906378
: Czasopismo naukowe

Objective: Acute kidney injury (AKI) is one of the most common problems in critically ill patients. AKI associates with poor outcome in ICU. The recognition of the prevalence and risk factors of AKI is important. This could lead to the prevention of AKI and improve patient’s outcome. This study aims to identify the prevalence, outcomes and independent risk factors of AKI in Thai surgical intensive care units.
Material and Method: We conducted the prospective cohort study from nine university-based SICUs. The patients were diagnosed AKI by Acute Kidney Injury Network (AKIN) classification. The types of RRT and outcomes including mortality were collected. The risk factors of AKI were identified.
Results: A total cohort of 4,652 patients was included for the present study. AKI was diagnosed in 786 (16.89%) patients. The ICU mortality was higher in patients with AKI (29.90% vs. 5.48%, p-value <0.001). Among patients with AKI staging, we found that those with AKIN III had higher ICU mortality compared to patients with AKIN II and AKIN I respectively (47.66% vs. 26.67% vs. 14.69%, p-value <0.001). Patients with AKI had higher 28 day-mortality compared with those without AKI (37.53% vs. 8.98%, p-value <0.001). The independent risk factors of AKI were higher APACHE II scores (OR 1.04, 95% CI 1.01-1.06, p-value = 0.001), lower serum albumin (OR 0.82, 95% CI 0.70-0.97, p-value = 0.020), organ failures which were in the gastrointestinal system (OR 1.53, 95% CI 1.13-2.08, p-value = 0.007), cardiovascular system (OR 1.95, 95% CI 1.34-2.83, p-value <0.001), neurological system (OR 1.37, 95% CI 1.02-1.85, p-value = 0.038) and urinary system (OR 7.00, 95% CI 5.21-9.40, p-value <0.001).
Conclusion: Acute kidney injury associates with poor outcomes including increased ICU and 28-day mortality. Independent risk factors of AKI in the present study were higher APACHE II scores, lower serum albumin and organ failures on admission.

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