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    Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study

    Access Status
    Fulltext not available
    Authors
    Srisawat, N.
    Sileanu, F.
    Murugan, R.
    Bellomo, R.
    Calzavacca, P.
    Cartin-Ceba, R.
    Cruz, D.
    Finn, Judith
    Hoste, E.
    Kashani, K.
    Ronco, C.
    Webb, S.
    Kellum, J.
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Srisawat, N. and Sileanu, F. and Murugan, R. and Bellomo, R. and Calzavacca, P. and Cartin-Ceba, R. and Cruz, D. et al. 2015. Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study. American Journal of Nephrology. 41 (1): pp. 81-88.
    Source Title
    American Journal of Nephrology
    DOI
    10.1159/000371748
    ISSN
    0250-8095
    School
    School of Nursing and Midwifery
    URI
    http://hdl.handle.net/20.500.11937/18389
    Collection
    • Curtin Research Publications
    Abstract

    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.

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