Clinical factors associated with hospital mortality in critically ill adult COVID-19 patients with AKI requiring CRRT: A multicenter study.
| Autor: | Cama-Olivares A, Tamhane A, Ortiz-Soriano V, Farrell D, Wen HH, Takeuchi T, Devansh P, Galasso F, Chen J, Chan L, Tolwani AJ, Nadkarni GN, Neyra JA |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Clinical nephrology [Clin Nephrol] 2024 Nov 20. Date of Electronic Publication: 2024 Nov 20. |
| DOI: | 10.5414/CN111404 |
| Abstrakt: | Background: Acute kidney injury (AKI) is a common complication of critically ill COVID-19 patients which is associated with adverse outcomes. We examined clinical factors associated with hospital mortality in critically ill adult COVID-19 patients with AKI who required continuous renal replacement therapy (CRRT). Materials and Methods: We conducted a multicenter retrospective cohort study including data from two large academic medical centers. Adult (age ≥ 18 years) patients with AKI and requiring CRRT admitted from March 2020 to April 2021 were included in the study. Patients with end-stage kidney disease or renal transplantation were excluded. Multivariable Poisson regression analyses were used to identify clinical predictors of hospital mortality. Results: A total of 178 patients were included. Patients were predominantly men (68.2%), 13.1% were Black, and 57.9% White. Median hospital and ICU length of stay were 20 days and 14 days, respectively. Mechanical ventilation and extracorporeal membrane oxygenation were utilized in 97.2% and 17.4% of patients, respectively. Overall, 130 (73.0%) patients died in the hospital (mortality rate of 2.7 per 100 person-days). In multivariable analyses, SOFA score ≥ 12 at ICU admission (MRRadj = 1.88; 95% CI 1.17 - 3.01) was associated with increased risk of mortality, while Black race (MRRadj = 0.56; 95% CI 0.31 - 1.01) was associated with a decreased risk of mortality. Conclusion: More than two-thirds of critically ill adult COVID-19 patients with AKI requiring CRRT died during hospitalization. SOFA score ≥ 12 at ICU admission was an independent predictor of hospital mortality, and Black patients had a lower risk of mortality. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|