TY - JOUR
T1 - Acute kidney injury in patients with severe sepsis in Finnish intensive care units
AU - Poukkanen, Meri
AU - Vaara, Suvi T
AU - Pettila, Ville Yrjo Olavi
AU - Kaukonen, Kirsi-Maija
AU - Korhonen, Anna Maija
AU - Hovilehto, Seppo
AU - Inkinen, Outi
AU - Laru-Sompa, Raili
AU - Kaminski, Tadeusz
AU - Reinikainen, Matti
AU - Lund, Vesa
AU - Karlsson, Sari
PY - 2013
Y1 - 2013
N2 - Severe sepsis is one of the leading causes of acute kidney injury (AKI). Patients with sepsis-associated AKI demonstrate high-hospital mortality. We evaluated the incidence of severe sepsis-associated AKI and its association with outcome in intensive care units (ICUs) in Finland. Methods This was a predetermined sub-study of the prospective, observational, multicentre FINNAKI study conducted in 17 ICUs during 1 September 2011 and 1 February 2012. All emergency ICU admissions and elective admissions exceeding 24 hours in the ICU were screened for presence of severe sepsis and AKI up to 5 days in ICU. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria and severe sepsis according to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) criteria. Results Of the 2901 included patients, severe sepsis was diagnosed in 918 (31.6 , 95 confidence interval [CI] 29.9-33.4 ) patients. Of these 918 patients, 488 (53.2 [95 CI 49.9-56.5 ) had AKI. The 90-day mortality rate was 38.1 (95 CI 33.7-42.5 ) for severe sepsis patients with AKI and 24.7 (95 CI 20.5-28.8 ) for those without AKI. After adjusting for covariates, KDIGO stage 3 AKI was associated with an increased risk for 90-day mortality with an adjusted odds ratio (OR) of 1.94 (95 CI 1.28-2.94), but stages 1 and 2 were not. Conclusions More than half of the patients with severe sepsis had AKI according to the KDIGO classification, and AKI stage 3 was independently associated with 90-day mortality.
AB - Severe sepsis is one of the leading causes of acute kidney injury (AKI). Patients with sepsis-associated AKI demonstrate high-hospital mortality. We evaluated the incidence of severe sepsis-associated AKI and its association with outcome in intensive care units (ICUs) in Finland. Methods This was a predetermined sub-study of the prospective, observational, multicentre FINNAKI study conducted in 17 ICUs during 1 September 2011 and 1 February 2012. All emergency ICU admissions and elective admissions exceeding 24 hours in the ICU were screened for presence of severe sepsis and AKI up to 5 days in ICU. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria and severe sepsis according to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) criteria. Results Of the 2901 included patients, severe sepsis was diagnosed in 918 (31.6 , 95 confidence interval [CI] 29.9-33.4 ) patients. Of these 918 patients, 488 (53.2 [95 CI 49.9-56.5 ) had AKI. The 90-day mortality rate was 38.1 (95 CI 33.7-42.5 ) for severe sepsis patients with AKI and 24.7 (95 CI 20.5-28.8 ) for those without AKI. After adjusting for covariates, KDIGO stage 3 AKI was associated with an increased risk for 90-day mortality with an adjusted odds ratio (OR) of 1.94 (95 CI 1.28-2.94), but stages 1 and 2 were not. Conclusions More than half of the patients with severe sepsis had AKI according to the KDIGO classification, and AKI stage 3 was independently associated with 90-day mortality.
UR - http://onlinelibrary.wiley.com/doi/10.1111/aas.12133/pdf
U2 - 10.1111/aas.12133
DO - 10.1111/aas.12133
M3 - Article
VL - 57
SP - 863
EP - 872
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 7
ER -