Differences in community, hospital and intensive care unit-acquired acute kidney injury: observational study in a nephrology service of a developing country
| Autor: | Célio A. Babosa, Silvia Q. Santos, Geraldo Bezerra da Silva Junior, Antonio Augusto C. Guimarães, Elizabeth De Francesco Daher, Krasnalhia Lívia S. Abreu, Rosa Maria Salani Mota, Alexandre Braga Libório, Carla Camila R. Bezerra, Rafael S. A. Lima, Elton J.B. Diniz |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty medicine.medical_treatment urologic and male genital diseases law.invention Cohort Studies law Intensive care Internal medicine medicine Humans Rifle Renal replacement therapy Intensive care medicine Developing Countries Aged business.industry Acute kidney injury General Medicine Acute Kidney Injury Middle Aged medicine.disease Intensive care unit female genital diseases and pregnancy complications Community hospital Intensive Care Units Multivariate Analysis Emergency medicine Female business Cohort study |
| Zdroj: | Clinical Nephrology. 78:449-455 |
| ISSN: | 0301-0430 |
| DOI: | 10.5414/cn107167 |
| Popis: | Background: Acute kidney in- jury (AKI) complicates more than 7% of all in-hospital patients. The aim of this study is to investigate the differences in community, hospital and intensive care unit-acquired AKI in patients undergoing nephrology con- sultation in a tertiary hospital in a developing country. Methods: An observational cohort study of all patients with AKI admitted to the General Hospital of Fortaleza, Brazil was conducted. RIFLE criteria were used to clas- sify the patients and to assess their associa- tion with death. Univariate and multivariate analyses were performed to investigate the factors associated with death. Results: Of 491 AKI patients undergoing nephrology consul- tation, the mean age was 55.2 ± 22.9 years. Community-acquired AKI was observed in 55% of cases, general ward-acquired in 29% and ICU-acquired in 15.3%. Late Nephrol- ogy consultation was observed, and the great majority of patients had "Failure" classifi- cation (90%) according to RIFLE criteria. Intermittent hemodialysis was required in 68% of cases. The overall in-hospital mor- tality was 23%. The in-hospital mortality was higher in ICU-acquired AKI (33.6%). Community-acquired AKI had a higher mortality than general ward-acquired AKI (23% vs. 11.6%, p = 0.001). Risk factors for death were infection (OR = 2.0, p = 0.003), neoplasms (OR = 1.89, p = 0.042), commu- nity acquired-AKI (OR = 1.27, p = 0.003), ICU acquired-AKI (OR = 2.76, p < 0.0001) and need for renal replacement therapy (OR = 2.64, p < 0.001). Conclusions: AKI is a frequent and frequently fatal condition. Mortality was higher in community and ICU-acquired than hospital ward-acquired AKI. |
| Databáze: | OpenAIRE |
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