Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
MetadataShow full item record
Background: Despite standardized definitions of acute kidney injury (AKI), there is wide variation in the reported rates of AKI and hospital mortality for patients with AKI. Variation could be due to actual differences in disease incidence, clinical course, or a function of data ascertainment and application of diagnostic criteria. Using standard criteria may help determine and compare the risk and outcomes of AKI across centers. Methods: In this cohort study of critically ill patients admitted to the intensive care units at six hospitals in four countries, we used KDIGO criteria to define AKI. The main outcomes were the occurrence of AKI and hospital mortality. Results: Of the 15,132 critically ill patients, 32% developed AKI based on serum creatinine criteria. After adjusting for differences in age, sex, and severity of illness, the odds ratio for AKI continued to vary across centers (odds ratio (OR), 2.57-6.04, p < 0.001). The overall, crude hospital mortality of patients with AKI was 27%, which also varied across centers after adjusting for KDIGO stage, differences in age, sex, and severity of illness (OR, 1.13-2.20, p < 0.001). The severity of AKI was associated with incremental mortality risk across centers. Conclusions: In this study, the absolute and severity-adjusted rates of AKI and hospital mortality rates for AKI varied across centers. Future studies should examine whether variation in the risk of AKI among centers is due to differences in clinical practice or process of care or residual confounding due to unmeasured factors.
Showing items related by title, author, creator and subject.
Injured adolescents, not just large children: Difference in care and outcome between adult and pediatric trauma centersMatsushima, K.; Schaefer, E.; Won, E.; Nichols, Pam; Frankel, H. (2013)Adolescent injury victims receive care at adult trauma centers (ATCs) and pediatric trauma centers (PTCs). The purpose of this study was to identify care variations and their impact on the outcome of adolescent trauma ...
Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence studyWeiss, S.; Fitzgerald, J.; Maffei, F.; Kane, J.; Rodriguez-Nunez, A.; Hsing, D.; Franzon, D.; Kee, S.; Bush, J.; Roy, J.; Thomas, N.; Nadkarni, V.; Fontela, P.; Tucci, M.; Dumistrascu, M.; Skippen, P.; Krahn, G.; Bezares, E.; Puig, G.; Puig-Ramos, A.; Garcia, R.; Villar, M.; Bigham, M.; Polanski, T.; Latifi, S.; Giebner, D.; Anthony, H.; Hume, J.; Galster, A.; Linnerud, L.; Sanders, R.; Hefley, G.; Madden, K.; Thompson, A.; Shein, S.; Gertz, S.; Han, Y.; Williams, Teresa; Hughes-Schalk, A.; Chandler, H.; Orioles, A.; Zielinski, E.; Doucette, A.; Orioles, A.; Zielinski, E.; Doucette, A.; Zebuhr, C.; Wilson, T.; Dimitriades, C.; Ascani, J.; Layburn, S.; Valley, S.; Markowitz, B.; Terry, J.; Morzov, R.; McInnes, A.; McArthur, J.; Woods, K.; Murkowski, K.; Spaeder, M.; Sharron, M.; Wheeler, D.; Beckman, E.; Frank, E.; Howard, K.; Carroll, C.; Nett, S.; Jarvis, D.; Patel, V.; Higgerson, R.; Christie, L.; Typpo, K.; Deschenes, J.; Kirby, A.; Uhl, T.; Rehder, K.; Cheifetz, I.; Wrenn, S.; Kypuros, K.; Ackerman, K.; Maffei, F.; Bloomquist, G.; Rizkalla, N.; Kimura, D.; Shah, S.; Tigges, C.; Su, F.; Barlow, C.; Michelson, K.; Wolfe, K.; Goodman, D.; Campbel, L.; Sorce, L.; Bysani, K.; Monjure, T.; Evans, M.; Totapally, B.; Chegondi, M.; Rodriguez, C.; Frazier, J. (2015)© 2015 Weiss et al.Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria ...
Improving health outcomes by preventing intensive care related infection in Malaysia Intensive Care Unit (INVEST study)Soh, Kim Lam (2012)Ventilator-associated pneumonia (VAP), catheter-related blood stream infection (CRBSI) and pressure ulcers (PU) are well recognized complications in intensive care units (ICUs). Many of these are preventable but can also ...