| Comparison of 2 acute renal failure severity scores to general scoring systems in the critically ill. | |
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MedLine Citation:
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PMID: 16860192 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Several proposed definitions for acute renal failure (ARF) exist, but little is known of their significance in clinical practice. We evaluated the ability to predict hospital mortality in 2 ARF-specific severity-of-illness scoring methods, the Risk, Injury, Failure, Loss, End-Stage Renal Disease (RIFLE) score and the score presented by Bellomo et al in 2001. METHODS: The study included 668 consecutive patients with 694 treatment episodes treated in 2 intensive care units (ICUs) in a university hospital within 11 months. ARF prevalence was classified according to the RIFLE and Bellomo scores. As references, we evaluated 2 general severity-of-illness scoring systems, the admission Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores. RESULTS: Admission SOFA scores and maximum RIFLE scores for the first 3 days in the ICU were independent predictors of hospital mortality by means of forward conditional logistic regression. In receiver operating characteristic analysis, SOFA and APACHE II scores performed better than ARF-specific scores, and discriminative powers for hospital mortality were only moderate for the RIFLE and Bellomo scores: areas under the curve were 0.653 (95% confidence interval, 0.588 to 0.719) and 0.587 (95% confidence interval, 0.514 to 0.660), respectively. CONCLUSION: Neither of the ARF-specific scoring methods presented good discriminative power regarding hospital mortality. However, maximum RIFLE score for the first 3 days in the ICU was found to be an independent predictor of hospital mortality, along with admission SOFA score. |
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Authors:
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Annika Ahlström; Anne Kuitunen; Seija Peltonen; Marja Hynninen; Minna Tallgren; Janne Aaltonen; Ville Pettilä |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 48 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-07-24 Completed Date: 2006-07-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
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Languages: eng Pagination: 262-8 Citation Subset: IM |
Affiliation:
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Intensive Care Unit, Department of Surgery, Division of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland. annika.ahlstrom@helsinki.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Critical Illness* Female Hospital Mortality* Hospitals, University / statistics & numerical data Humans Intensive Care Units / statistics & numerical data Kidney Failure / classification*, pathology* Male Middle Aged Models, Theoretical* Patient Admission Predictive Value of Tests ROC Curve Severity of Illness Index* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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