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10.1186/s13054-015-0848-2

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suck abstract from ncbi


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pmid25887685      Crit+Care 2015 ; 19 (1): ä
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  • Predicting one-year mortality of critically ill patients with early acute kidney injury: data from the prospective multicenter FINNAKI study #MMPMID25887685
  • Poukkanen M; Vaara ST; Reinikainen M; Selander T; Nisula S; Karlsson S; Parviainen I; Koskenkari J; Pettilä V
  • Crit Care 2015[]; 19 (1): ä PMID25887685show ga
  • Introduction: No predictive models for long-term mortality in critically ill patients with acute kidney injury (AKI) exist. We aimed to develop and validate two predictive models for one-year mortality in patients with AKI based on data (1) on intensive care unit (ICU) admission and (2) on the third day (D3) in the ICU. Methods: This substudy of the FINNAKI study comprised 774 patients with early AKI (diagnosed within 24 hours of ICU admission). We selected predictors a priori based on previous studies, clinical judgment, and differences between one-year survivors and non-survivors in patients with AKI. We validated the models internally with bootstrapping. Results: Of 774 patients, 308 (39.8%, 95% confidence interval (CI) 36.3 to 43.3) died during one year. Predictors of one-year mortality on admission were: advanced age, diminished premorbid functional performance, co-morbidities, emergency admission, and resuscitation or hypotension preceding ICU admission. The area under the receiver operating characteristic curve (AUC) (95% CI) for the admission model was 0.76 (0.72 to 0.79) and the mean bootstrap-adjusted AUC 0.75 (0.74 to 0.75). Advanced age, need for mechanical ventilation on D3, number of co-morbidities, higher modified SAPS II score, the highest bilirubin value by D3, and the lowest base excess value on D3 remained predictors of one-year mortality on D3. The AUC (95% CI) for the D3 model was 0.80 (0.75 to 0.85) and by bootstrapping 0.79 (0.77 to 0.80). Conclusions: The prognostic performance of the admission data-based model was acceptable, but not good. The D3 model for one-year mortality performed fairly well in patients with early AKI. Electronic supplementary material: The online version of this article (doi:10.1186/s13054-015-0848-2) contains supplementary material, which is available to authorized users.
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