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Evaluation of determinants of acute kidney injury and mortality among patients attending intensive care unit: A retrospective study

Introduction: Acute Kidney Injury (AKI) in intensive care unit (ICU) portends worse outcomes and attendant with high mortality. Early identification of high risk patients can improve their outcomes and may reduce ICU mortality rate.

Methodology: A retrospective data review of patient attending ICU during 1 year was performed. All the patients were divided into two groups based upon their outcomes (AKI/non-AKI, fatal/non-fatal cases). Risk factors of AKI and mortality were identified by using regression analysis.

Results: A total 906 patients (mean age: 53.6 ± 15.3, male: 58.2%) were included into the study. The mean length of ICU stay was 14.4 ± 3.3 days. AKI was observed in 487 (53.8%) patients with varying severity including AKIN-I in 89/487 (18.3%), AKIN-II in 137/487 (28.2%) and AKIN-III in 261/487 (53.5%) cases. Old age (OR 2.8) diabetic patients (OR 1.9) with high SOFA (OR 2.7) and APACHE-II scores (OR 3.1) requiring IMV on admission (OR 4.2) were found to be significantly associated with AKI. Overall mortality in our study was 29.5%. Pulmonary (OR 1.7) and neurological (OR 3.3) causes of ICU admission, AKI (OR 6.2), AKIN-III (OR 3.2), high SOFA (OR 1.6) and APACHE II scores (OR 2.3), need of IMV (OR 7.2) and dialysis (OR 4.6) were significant predictors of mortality in our study.

Conclusion: AKI was found among half of the patients attending ICU and significantly associated with in hospital mortality. Early identification of high risk patients can be useful to reduce the burden of AKI and mortality in ICU.

Author(s): Jun Zhu, Hong-Guang Chen, Rong Yang, Lan Sun, Qi- Yin Zou