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Content Provider | World Health Organization (WHO)-Global Index Medicus |
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Author | Harris, Donald G. McCrone, Michelle P. Koo, Grace Weltz, Adam S. Chiu, William C. Scalea, Thomas M. Diaz, Jose J. Lissauer, Matthew E. |
Description | Author Affiliation: Harris DG ( Division of General Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD. Electronic address: dharris@smail.umaryland.edu.); McCrone MP ( Division of General Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.); Koo G ( Division of General Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.); Weltz AS ( Division of General Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD.); Chiu WC ( R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.); Scalea TM ( R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.); Diaz JJ ( R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD.); Lissauer ME ( R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD) |
Abstract | PURPOSE: Acute kidney injury (AKI) is common in critically ill patients but is poorly defined in surgical patients. We studied AKI in a representative cohort of critically ill surgical patients. METHODS: This was a retrospective 1-year cohort study of general surgical intensive care unit patients. Patients were identified from a prospective database, and clinical data were reviewed. Acute kidney injury events were defined by risk, injury, failure, loss, and end-stage renal classification criteria. Outcomes were inpatient and 1-year mortality, inpatient lengths of stay, and discharge renal function. Risk factors for AKI and outcomes were compared by univariate and multivariate analyses. RESULTS: Of 624 patients, 296 (47%) developed AKI. Forty-two percent of events were present upon admission, whereas 36% occurred postoperatively. Risk, injury, failure, loss, and end-stage renal classification distributions by grade were as follows: risk, 152 (51%); injury, 69 (23%); and failure, 75 (25%). Comorbid diabetes, emergency admission, major surgery, sepsis, and illness severity were independently associated with renal dysfunction. Patients with AKI had significantly worse outcomes, including increased inpatient and 1-year mortality. Acute kidney injury starting before admission was associated with worse renal dysfunction and greater renal morbidity than de novo inpatient events. CONCLUSIONS: Acute kidney injury is common in critically ill surgical patients and is associated with increased mortality, persisting renal impairment and greater resource use. |
File Format | HTM / HTML |
ISSN | 08839441 |
Issue Number | 1 |
Volume Number | 30 |
e-ISSN | 15578615 |
Journal | Journal of Critical Care |
Language | English |
Publisher | Elsevier |
Publisher Date | 2015-02-01 |
Publisher Place | United States |
Access Restriction | Subscribed |
Subject Keyword | Discipline Critical Care Acute Kidney Injury Epidemiology Renal Insufficiency Surgical Procedures, Operative Etiology Mortality Aged Analysis Of Variance Comorbidity Critical Illness Female Humans Length Of Stay Male Middle Aged Patient Discharge Postoperative Complications Retrospective Studies Risk Factors Sepsis Journal Article |
Content Type | Text |
Resource Type | Article |
Subject Domain (in MeSH) | Eukaryota Bacterial Infections and Mycoses Male Urogenital Diseases Pathological Conditions, Signs and Symptoms Therapeutics Surgical Procedures, Operative Investigative Techniques Persons Health Care Quality, Access, and Evaluation |
Subject | Critical Care and Intensive Care Medicine |
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