OBJECTIVE: To evaluate the prognostic value of hemoglobin levels in critically ill patients with acute renal failure (ARF) requiring dialysis. DESIGN AND SETTING: A prospective observational cohort study in two adult medical ICUs. PATIENTS: 206 consecutive patients with ARF who required dialysis. Overall 28-day mortality was 48%. MEASUREMENTS AND RESULTS: At ICU admission mean hemoglobin level was 9.1+/-2.1 g/dl. By ROC curve analysis the threshold value of hemoglobin with the highest sensibility/specificity was 9 g/dl. At baseline 63% of patients had anemia, defined as initial hemoglobin below 9 g/dl. Kaplan-Meier analysis showed that these patients had lower survival rate than those with hemoglobin above 9 g/dl. By multivariable analysis three factors were independently associated with 28-day death: hemoglobin lower than 9 g/dl (adjusted odds ratio 2.4, 95% CI 1.1-5.2), age, and SOFA score. Based on age and SOFA a matched cohort analysis of 67 pairs of ARF patients with or without anemia found similar results regarding the negative impact of anemia on outcome. Finally, a multivariable logistic regression analysis on matched cohort identified hemoglobin level below 9 g/dl (adjusted odds ratio 1.32, 95%CI 1.15-1.46), continuous renal replacement therapy, and vasoactive therapy as independent predictors of 28-day death. CONCLUSIONS: These results suggest that initial hemoglobin level could be helpful in identifying patients with ARF requiring dialysis at high risk of death.
OBJECTIVE: To evaluate the prognostic value of hemoglobin levels in critically illpatients with acute renal failure (ARF) requiring dialysis. DESIGN AND SETTING: A prospective observational cohort study in two adult medical ICUs. PATIENTS: 206 consecutive patients with ARF who required dialysis. Overall 28-day mortality was 48%. MEASUREMENTS AND RESULTS: At ICU admission mean hemoglobin level was 9.1+/-2.1 g/dl. By ROC curve analysis the threshold value of hemoglobin with the highest sensibility/specificity was 9 g/dl. At baseline 63% of patients had anemia, defined as initial hemoglobin below 9 g/dl. Kaplan-Meier analysis showed that these patients had lower survival rate than those with hemoglobin above 9 g/dl. By multivariable analysis three factors were independently associated with 28-day death: hemoglobin lower than 9 g/dl (adjusted odds ratio 2.4, 95% CI 1.1-5.2), age, and SOFA score. Based on age and SOFA a matched cohort analysis of 67 pairs of ARFpatients with or without anemia found similar results regarding the negative impact of anemia on outcome. Finally, a multivariable logistic regression analysis on matched cohort identified hemoglobin level below 9 g/dl (adjusted odds ratio 1.32, 95%CI 1.15-1.46), continuous renal replacement therapy, and vasoactive therapy as independent predictors of 28-day death. CONCLUSIONS: These results suggest that initial hemoglobin level could be helpful in identifying patients with ARF requiring dialysis at high risk of death.
Authors: R Moreno; J L Vincent; R Matos; A Mendonça; F Cantraine; L Thijs; J Takala; C Sprung; M Antonelli; H Bruining; S Willatts Journal: Intensive Care Med Date: 1999-07 Impact factor: 17.440
Authors: Howard L Corwin; Andrew Gettinger; Ronald G Pearl; Mitchell P Fink; Mitchell M Levy; Edward Abraham; Neil R MacIntyre; M Michael Shabot; Mei-Sheng Duh; Marc J Shapiro Journal: Crit Care Med Date: 2004-01 Impact factor: 7.598
Authors: John Michael Elliot; Tanit Virankabutra; Stephen Jones; Surasak Tanudsintum; Graham Lipkin; Susan Todd; Julian Bion Journal: Crit Care Date: 2003-04-24 Impact factor: 9.097
Authors: Peter Andrews; Elie Azoulay; Massimo Antonelli; Laurent Brochard; Christian Brun-Buisson; Daniel de Backer; Geoffrey Dobb; Jean-Yves Fagon; Herwig Gerlach; Johan Groeneveld; Jordi Mancebo; Philipp Metnitz; Stefano Nava; Jerome Pugin; Michael Pinsky; Peter Radermacher; Christian Richard; Robert Tasker Journal: Intensive Care Med Date: 2006-02-01 Impact factor: 17.440
Authors: Brian M Fuller; Mithil Gajera; Christa Schorr; David Gerber; R Phillip Dellinger; Joseph Parrillo; Sergio Zanotti Journal: J Emerg Med Date: 2012-03-24 Impact factor: 1.484
Authors: Luigi Tarantini; Fabrizio Oliva; Silvia Cantoni; Giovanni Cioffi; Virginia Agnoletto; Gianfranco Alunni; Francesca De Cian; Andrea Di Lenarda; Donata Lucci; Giovanni Pulignano; Laura Scelsi; Aldo Pietro Maggioni; Luigi Tavazzi Journal: Intern Emerg Med Date: 2011-05-05 Impact factor: 3.397
Authors: Andreas H Kramer; David A Zygun; Thomas P Bleck; Aaron S Dumont; Neal F Kassell; Bart Nathan Journal: Neurocrit Care Date: 2008-12-31 Impact factor: 3.210
Authors: Camila E Rodrigues; Talita R Sanches; Rildo A Volpini; Maria H M Shimizu; Patrícia S Kuriki; Niels O S Camara; Antonio C Seguro; Lúcia Andrade Journal: PLoS One Date: 2012-01-03 Impact factor: 3.240
Authors: Ilana Levy Korkes; Gustavo Schvartsman; Ilson Jorge Lizuka; Beata Marie Quinto; Maria Aparecida Dalboni; Maria Eugênia Canziani; Sergio Antonio Draibe; Virgilio Gonçalves Pereira; Bento Fortunato Cardoso Dos Santos; Julio Cesar Martins Monte; Marcelino de Souza Durão Junior; Marcelo Costa Batista; Oscar Fernando Pavão Dos Santos; Miguel Angelo de Góes Junior; Miguel Cendoroglo Neto Journal: Einstein (Sao Paulo) Date: 2013-12
Authors: Didier Payen; Anne Cornélie de Pont; Yasser Sakr; Claudia Spies; Konrad Reinhart; Jean Louis Vincent Journal: Crit Care Date: 2008-06-04 Impact factor: 9.097
Authors: Joon Seok Choi; Young A Kim; Yong Un Kang; Chang Seong Kim; Eun Hui Bae; Seong Kwon Ma; Young-Keun Ahn; Myung Ho Jeong; Soo Wan Kim Journal: PLoS One Date: 2013-09-24 Impact factor: 3.240