Abstract
BackgroundAcute kidney injury (AKI) is still characterized by a high mortality rate. While most patients with AKI are admitted in conventional medical units, current available data are still obtained from studies designed for patients admitted in intensive care units (ICU). Our study aimed to elaborate and validate an in-hospital death prognosis score for AKI admitted in conventional medical care units.MethodsWe included two prospective cohorts of consecutive patients with AKI admitted between 2001 and 2004 (elaboration cohort (EC)) and between 2010 and 2014 (validation cohort (VC)). We developed a scoring system from clinical and biological parameters recorded at admission from the EC to predict in-hospital mortality. This score was then tested for validation in the VC.ResultsThree-hundred and twenty-three and 534 patients were included in the EC and VC cohorts, respectively. The proportion of in-hospital death were 15.5% (EC) and 8.9% (VC), mainly due to sepsis. The parameters independently associated with the in-hospital death in the EC were Glasgow score, oxygen requirement, fluid overload, blood diastolic pressure, multiple myeloma and prothrombin time. The in-hospital death prognosis score AUC was 0.845 +/− 0.297 (p < 0.001) after validation in the VC.ConclusionsOur in-hospital death prognosis score is the first to be prospectively developed and validated for AKI admitted in a conventional medical care unit. Based on current parameters, easily collected at time of admission, this score could be a useful tool for physicians and nephrologists to determine the in-hospital death prognosis of this AKI population.
Highlights
Acute kidney injury (AKI) is still characterized by a high mortality rate
Our study aimed to elaborate and validate an in-hospital death prognosis score for AKI admitted in conventional medical care units
Patients All patients admitted for AKI to the nephrology unit of the University Hospital of Besançon between January 2001 and December 2004 (score elaboration cohort (EC)) and between January 2010 and December 2013 (score validation cohort (VC)) were prospectively considered for inclusion
Summary
Acute kidney injury (AKI) is still characterized by a high mortality rate. While most patients with AKI are admitted in conventional medical units, current available data are still obtained from studies designed for patients admitted in intensive care units (ICU). Acute kidney injury (AKI) is defined as deterioration of renal function over a short period [1]. This definition has been formalized for optimal data comparison between clinical studies thanks to the 2004 RIFLE [2], 2007 AKIN [3] and 2012 KDIGO [4] classifications. These classifications determine several AKI stages based on either an increase in creatinine or decrease in. The incidence of AKI continuously increases from about 11% per year, in male and elderly populations [8].
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