Kristianne Rachel P Medina-Liabres1, Jong Cheol Jeong1, Hyung Jung Oh2,3, Jung Nam An4, Jung Pyo Lee5,6, Dong Ki Kim6, Dong-Ryeol Ryu7,8, Sejoong Kim1. 1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2. Ewha Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea. 3. Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea. 4. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea. 5. Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 6. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 7. Department of Internal Medicine, Ewha Womans University, Seoul, Republic of Korea. 8. Tissue Injury Defense Research Center, Ewha Womans University, Seoul, Republic of Korea.
Abstract
Background: Because of high cost of continuous renal replacement therapy (CRRT) and the high mortality rate among severe acute kidney injury patients, careful identification of patients who will benefit from CRRT is warranted. This study determined factors associated with mortality among critically ill patients requiring CRRT. Methods: This was a retrospective observational study of 414 patients admitted to the intensive care unit of four hospitals in South Korea who received CRRT from June 2017 to September 2018. Patients were divided according to degree of fluid overload (FO) and disease severity. The Cox proportional hazards model was used to explore the effect of relevant variables on mortality. Results: In-hospital mortality rate was 57.2%. Ninety-day mortality rate was 58.5%. Lower creatinine and blood pH were significant predictors of mortality. A one-unit increase in the Sequential Organ Failure Assessment (SOFA) score was associated with increased risk of and 90-day mortality (hazard ratio [HR], 1.07; p < 0.001). The risk of 90-day mortality in FO patients was 57.2% (p < 0.001) higher than in those without FO. High SOFA score was associated with increased risk for 90-day mortality (HR, 1.79; p = 0.03 and HR, 3.05; p = 0.001) in patients without FO and with FO ≤ 10%, respectively. The highest mortality rates were in patients with FO > 10%, independent of disease severity. Conclusion: FO increases the risk of mortality independent of other factors, including severity of acute illness. Prevention of FO should be a priority, especially when managing the critically ill.
Background: Because of high cost of continuous renal replacement therapy (CRRT) and the high mortality rate among severe acute kidney injurypatients, careful identification of patients who will benefit from CRRT is warranted. This study determined factors associated with mortality among critically illpatients requiring CRRT. Methods: This was a retrospective observational study of 414 patients admitted to the intensive care unit of four hospitals in South Korea who received CRRT from June 2017 to September 2018. Patients were divided according to degree of fluid overload (FO) and disease severity. The Cox proportional hazards model was used to explore the effect of relevant variables on mortality. Results: In-hospital mortality rate was 57.2%. Ninety-day mortality rate was 58.5%. Lower creatinine and blood pH were significant predictors of mortality. A one-unit increase in the Sequential Organ Failure Assessment (SOFA) score was associated with increased risk of and 90-day mortality (hazard ratio [HR], 1.07; p < 0.001). The risk of 90-day mortality in FO patients was 57.2% (p < 0.001) higher than in those without FO. High SOFA score was associated with increased risk for 90-day mortality (HR, 1.79; p = 0.03 and HR, 3.05; p = 0.001) in patients without FO and with FO ≤ 10%, respectively. The highest mortality rates were in patients with FO > 10%, independent of disease severity. Conclusion: FO increases the risk of mortality independent of other factors, including severity of acute illness. Prevention of FO should be a priority, especially when managing the critically ill.
Authors: Mirela Tiglis; Ileana Peride; Iulia Alexandra Florea; Andrei Niculae; Lucian Cristian Petcu; Tiberiu Paul Neagu; Ionel Alexandru Checherita; Ioana Marina Grintescu Journal: Int J Environ Res Public Health Date: 2022-02-21 Impact factor: 3.390
Authors: Hye Won Kim; Sejoong Kim; Jung Hun Ohn; Nak-Hyun Kim; Jongchan Lee; Eun Sun Kim; Yejee Lim; Jae Ho Cho; Hee Sun Park; Jiwon Ryu; Sun-Wook Kim Journal: Kidney Res Clin Pract Date: 2021-12-02
Authors: Charat Thongprayoon; Yeshwanter Radhakrishnan; Wisit Cheungpasitporn; Tananchai Petnak; Fawad Qureshi; Michael A Mao; Kianoush B Kashani Journal: Can J Kidney Health Dis Date: 2022-07-26