Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study

Srisawat, Nattachai, Sileanu, Florentina E., Murugan, Raghavan, Bellomo, Rinaldo, Calzavacca, Paolo, Cartin-Ceba, Rodrigo, Cruz, Dinna, Finn, Judith, Hoste, Eric A., Kashani, Kianoush, Ronco, Claudio, Webb, Steve, Kellum, John A. and on behalf of the Acute Kidney Injury-6 Study Group (2015) Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study. American Journal of Nephrology, 41 1: 81-88. doi:10.1159/000371748


Author Srisawat, Nattachai
Sileanu, Florentina E.
Murugan, Raghavan
Bellomo, Rinaldo
Calzavacca, Paolo
Cartin-Ceba, Rodrigo
Cruz, Dinna
Finn, Judith
Hoste, Eric A.
Kashani, Kianoush
Ronco, Claudio
Webb, Steve
Kellum, John A.
on behalf of the Acute Kidney Injury-6 Study Group
Title Variation in risk and mortality of acute kidney injury in critically ill patients: A multicenter study
Journal name American Journal of Nephrology   Check publisher's open access policy
ISSN 0250-8095
1421-9670
Publication date 2015-02-01
Sub-type Article (original research)
DOI 10.1159/000371748
Open Access Status Not Open Access
Volume 41
Issue 1
Start page 81
End page 88
Total pages 8
Place of publication Basel, Switzerland
Publisher S. Karger AG
Language eng
Formatted abstract
Background: Despite standardized definitions of acute kidney injury (AKI), there is wide variation in the reported rates of AKI and hospital mortality for patients with AKI. Variation could be due to actual differences in disease incidence, clinical course, or a function of data ascertainment and application of diagnostic criteria. Using standard criteria may help determine and compare the risk and outcomes of AKI across centers.

Methods: In this cohort study of critically ill patients admitted to the intensive care units at six hospitals in four countries, we used KDIGO criteria to define AKI. The main outcomes were the occurrence of AKI and hospital mortality.

Results: Of the 15,132 critically ill patients, 32% developed AKI based on serum creatinine criteria. After adjusting for differences in age, sex, and severity of illness, the odds ratio for AKI continued to vary across centers (odds ratio (OR), 2.57-6.04, p < 0.001). The overall, crude hospital mortality of patients with AKI was 27%, which also varied across centers after adjusting for KDIGO stage, differences in age, sex, and severity of illness (OR, 1.13-2.20, p < 0.001). The severity of AKI was associated with incremental mortality risk across centers.

Conclusions: In this study, the absolute and severity-adjusted rates of AKI and hospital mortality rates for AKI varied across centers. Future studies should examine whether variation in the risk of AKI among centers is due to differences in clinical practice or process of care or residual confounding due to unmeasured factors.
Keyword Acute kidney injury (AKI)
Mortality
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Nursing, Midwifery and Social Work Publications
 
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Created: Mon, 19 Oct 2015, 18:56:15 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work