Risk factors for death among critically ill patients with acute renal failure
CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospit...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
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| Series: | São Paulo Medical Journal |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802006000500004&lng=en&tlng=en |
| _version_ | 1818128726392569856 |
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| author | Geraldo Bezerra da Silva Júnior Elizabeth De Francesco Daher Rosa Maria Salani Mota Francisco Albano Menezes |
| author_facet | Geraldo Bezerra da Silva Júnior Elizabeth De Francesco Daher Rosa Maria Salani Mota Francisco Albano Menezes |
| author_sort | Geraldo Bezerra da Silva Júnior |
| collection | DOAJ |
| description | CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment. |
| first_indexed | 2024-12-11T07:37:50Z |
| format | Article |
| id | doaj.art-dfa40044ce644a6e9a57ab29b2216cf0 |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-11T07:37:50Z |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-dfa40044ce644a6e9a57ab29b2216cf02022-12-22T01:15:40ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460124525726310.1590/S1516-31802006000500004S1516-31802006000500004Risk factors for death among critically ill patients with acute renal failureGeraldo Bezerra da Silva Júnior0Elizabeth De Francesco Daher1Rosa Maria Salani Mota2Francisco Albano Menezes3Universidade Federal do CearáUniversidade Federal do CearáUniversidade Federal do CearáUniversidade Federal do CearáCONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802006000500004&lng=en&tlng=enAcute kidney failureRisk factorsOliguriaSepsisPrognosis |
| spellingShingle | Geraldo Bezerra da Silva Júnior Elizabeth De Francesco Daher Rosa Maria Salani Mota Francisco Albano Menezes Risk factors for death among critically ill patients with acute renal failure São Paulo Medical Journal Acute kidney failure Risk factors Oliguria Sepsis Prognosis |
| title | Risk factors for death among critically ill patients with acute renal failure |
| title_full | Risk factors for death among critically ill patients with acute renal failure |
| title_fullStr | Risk factors for death among critically ill patients with acute renal failure |
| title_full_unstemmed | Risk factors for death among critically ill patients with acute renal failure |
| title_short | Risk factors for death among critically ill patients with acute renal failure |
| title_sort | risk factors for death among critically ill patients with acute renal failure |
| topic | Acute kidney failure Risk factors Oliguria Sepsis Prognosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802006000500004&lng=en&tlng=en |
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