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

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 ap...

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Main 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.
Format: Journal Article
Published: 2015
Online Access:http://hdl.handle.net/20.500.11937/18389
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author 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.
author_facet 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.
author_sort Srisawat, N.
building Curtin Institutional Repository
collection Online Access
description 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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spelling curtin-20.500.11937-183892017-09-13T13:43:07Z Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study 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. 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. 2015 Journal Article http://hdl.handle.net/20.500.11937/18389 10.1159/000371748 restricted
spellingShingle 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.
Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
title Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
title_full Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
title_fullStr Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
title_full_unstemmed Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
title_short Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
title_sort variation in risk and mortality of acute kidney injury in critically ill patients: a multicenter study
url http://hdl.handle.net/20.500.11937/18389