#2921 The SOFA score: predictive factor of nephrotoxicity post injection of iodized PDC in the emergency room

Abstract

Abstract Background and Aims Nephrotoxicity following injection of iodinated contrast media is the leading cause of iatrogenic acute renal failure. Its incidence is variable taking into account the study population as well as associated factors. The aim: To study the contribution of the SOFA score in the prediction of nephrotoxicity post injection of iodized PDCs in septic patients. Method This was a prospective, single-center study over a six-month period. Patients aged over 14 years and having undergone an injection of iodinated contrast products were included. Nephropathy in this context is defined by an elevation in plasma creatinine of more than 25% within 48 to 72 hours following injection and in the absence of other etiologies. Results During the study period, 135 patients were collected with a mean age of 46 ± 18 years and range of 16 to 97 years. The gender ratio was 3.2 with a male predominance. Hypertension and diabetes were the most noted comorbidities (20.7%, 20%). Clinical examination revealed polypnea in 26% of cases, desaturation in 11.8%, tachycardia (27%) and oliguria (5.2%). Fourteen patients had an altered state of consciousness with coma in 10.4% of cases. Twenty-one patients (15.6%) were febrile on admission. The incidence of nephropathy post injection of iodized PDCs was 15.6%. 111 patients (82.8%) benefited from per-procedure hydration. Emergency mortality was 4.4% (n=6). The SOFA score was calculated in 24 patients with a median score of three. Nineteen patients (14.1%) had a score ranging from two to six, which predicts an intra-hospital mortality risk of 10%. Four patients (2.9%) had a score between 7 and 9, which reflects a risk of death of 15 to 20%. In univariate analysis, the SOFA score was calculated in six patients with nephrotoxicity and in 18 patients who did not develop nephrotoxicity. A score between seven and nine was significantly associated with the risk of developing nephrotoxicity (14.3% vs 0.9%) with p=0.012 and ORb=19.2, 95% CI [1.8-196.8]. Conclusion The incidence of post-iodized PDC injection nephropathy was high in emergency rooms. Among the independent factors associated with nephrotoxicity, the SOFA score was found to be.