Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk?
| Autor: | Dafydd Phillips, Rachel Hooper, Mo Hu, Vikas Lodhi, John Geen, Ella Toynton, Mohamed Hassan, Aled O. Phillips, Gareth Roberts, Sonal Lodhi, Kimberly Saddler, Rowan McCarthy, Hemanth Bolusani, Paul Mizen, Catherine Grose |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Risk management tools urologic and male genital diseases Sepsis AKI chronic renal failure Epidemiology medicine Risk factor Intensive care medicine Acute tubular necrosis Transplantation chronic renal insufficiency urogenital system business.industry Acute kidney injury medicine.disease R1 female genital diseases and pregnancy complications acute tubular necrosis Nephrology Emergency medicine Cohort Contents epidemiology Risk assessment business |
| Zdroj: | Clinical Kidney Journal |
| ISSN: | 2048-8513 2048-8505 |
| DOI: | 10.1093/ckj/sfv080 |
| Popis: | Background We examined the prevalence of acute kidney injury (AKI) risk factors in the emergency medical unit, generated a modified risk assessment tool and tested its ability to predict AKI. \ud \ud \ud Methods A total of 1196 patients admitted to medical admission units were assessed for patient-associated AKI risk factors. Subsequently, 898 patients were assessed for a limited number of fixed risk factors with the addition of hypotension and sepsis. This was correlated to AKI episodes. \ud \ud \ud Results In the first cohort, the prevalence of AKI risk factors was 2.1 ± 2.0 per patient, with a positive relationship between age and the number of risk factors and a higher number of risk factors in patients ≥65 years. In the second cohort, 12.3% presented with or developed AKI. Patients with AKI were older and had a higher number of AKI risk factors. In the AKI cohort, 72% of the patients had two or more AKI risk factors compared with 43% of the cohort with no AKI. When age ≥65 years was added as an independent risk factor, 84% of those with AKI had two or more AKI risk factors compared with 55% of those with no AKI. Receiver operating characteristic analysis suggests that the use of common patient-associated known AKI risk factors performs no better than age alone as a predictor of AKI. \ud \ud \ud Conclusions Detailed assessment of well-established patient-associated AKI risk factors may not facilitate clinicians to apportion risk. This suggests that additional work is required to develop a more sensitive validated AKI-predictive tool that would be useful in this clinical setting. |
| Databáze: | OpenAIRE |
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