Abstract No.: ABS0279: Retrospective analysis of acute dialysis in ICU setting in a tertiary care hospital

Abstract

Background and Aims:To study the clinical profile and evaluate in-hospital and 30-day mortality in patients undergoing acute dialysis in the intensive care unit (ICU) in a multi-disciplinary hospital.Methods:Thirty one consecutive patients who underwent acute dialysis between August 2020 and August 2021 in ICU were included in the study. All patients were evaluated with basic clinical assessment, laboratory investigations, indications for dialysis, the process of dialysis, the time lag for initiation of dialysis following the clinician’s orders, an increase in requirement of vasopressors following dialysis, and access for dialysis. Any other complications occurring during dialysis were also noted. All the patients were further evaluated with sequential organ failure assessment (SOFA) score and all the parameters mentioned above as possible predictors of in-hospital and 30-day mortality with logistic regression analysis.Results:Out of 31 patients, 17 had sepsis, six had acute febrile illness, and five had acute myocardial infarction, resulting in dialysis. Common indications were anuria >24 hours, pulmonary oedema, and severe metabolic acidosis. SOFA score was an independent predictor of both in-hospital (p = 0.03) and 30-day mortality (p = 0.048) with an increase of each unit, increasing the 30-day mortality by 1.5 times. Sustained low-efficiency daily dialysis (SLEDD) had 13.5 times higher mortality risk compared to ischaemic heart disease (IHD), inferring that patients with greater haemodynamic lability or vasopressor requirement had higher 30-day mortality.Conclusion:Sepsis remains the most common cause of dialysis in ICU, followed by acute febrile illness, including leptospirosis and dengue. Each unit of increase in SOFA score increases the 30-day mortality by 1.5 times in these patients. SLEDD was associated with a 13.5 times increased risk of mortality over IHD, inferring that patients with haemodynamic lability or vasopressor requirement had higher 30-day mortality.