6 research outputs found
Three-year mortality in 30-day survivors of critical care with acute kidney injury: data from the prospective observational FINNAKI study
Background
The role of an episode of
acute kidney injury (AKI) in long-term mortality among initial survivors
of critical illness is controversial. We aimed to determine whether AKI
is independently associated with decreased survival at 3Â years among
30-day survivors of intensive care.
Results
We included 2336 30-day
survivors of intensive care enrolled in the FINNAKI study conducted in
seventeen medical–surgical ICUs in Finland during a 5-month period in
2011–2012. The incidence of AKI, defined by the Kidney Disease:
Improving Global Outcomes criteria, was 34.6%, and 192 (8.3%) commenced
RRT. The 3-year mortality among AKI patients was 23.5% (95% CI
20.6–26.4%) compared to 18.9% (17.0–20.9%) of patients without AKI, p = 0.01.
However, after adjustments using Cox proportional hazards regression,
AKI was not associated with decreased 3-year survival (HR 1.05; CI 95%
0.86–1.27), whereas advanced age, poor pre-morbid functional
performance, and presence of several comorbidities were. Additionally,
we matched AKI patients to non-AKI patients 1:1 according to age,
gender, presence of severe sepsis, and a propensity score to develop
AKI. In the well-balanced matched cohort, 3-year mortality among AKI
patients was 136 of 662 (20.5%; 17.5–23.6%) and among matched non-AKI
patients 143 of 662 (21.6%; 18.5–24.7%), p = 0.687.
Neither AKI nor RRT was associated with decreased survival at 3Â years
in the sensitivity analyses that excluded patients (1) with chronic
kidney disease, (2) with AKI not commenced renal replacement therapy
(RRT), and (3) with estimated pre-admission creatinine, chronic kidney
disease, or AKI stage 1.
Conclusion
AKI was not an independent
risk factor for 3-year mortality among 30-day survivors. Increased
3-year mortality among patients with AKI who survive critical illness
may not be related to AKI per se, but rather to advanced age and
pre-existing comorbidities.
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Three-year mortality in 30-day survivors of critical care with acute kidney injury : data from the prospective observational FINNAKI study
Background: The role of an episode of acute kidney injury (AKI) in long-term mortality among initial survivors of critical illness is controversial. We aimed to determine whether AKI is independently associated with decreased survival at 3 years among 30-day survivors of intensive care. Results: We included 2336 30-day survivors of intensive care enrolled in the FINNAKI study conducted in seventeen medical-surgical ICUs in Finland during a 5-month period in 2011-2012. The incidence of AKI, defined by the Kidney Disease: Improving Global Outcomes criteria, was 34.6%, and 192 (8.3%) commenced RRT. The 3-year mortality among AKI patients was 23.5% (95% CI 20.6-26.4%) compared to 18.9% (17.0-20.9%) of patients without AKI, p = 0.01. However, after adjustments using Cox proportional hazards regression, AKI was not associated with decreased 3-year survival (HR 1.05; CI 95% 0.86-1.27), whereas advanced age, poor pre-morbid functional performance, and presence of several comorbidities were. Additionally, we matched AKI patients to non-AKI patients 1: 1 according to age, gender, presence of severe sepsis, and a propensity score to develop AKI. In the well-balanced matched cohort, 3-year mortality among AKI patients was 136 of 662 (20.5%; 17.5-23.6%) and among matched non-AKI patients 143 of 662 (21.6%; 18.5-24.7%), p = 0.687. Neither AKI nor RRT was associated with decreased survival at 3 years in the sensitivity analyses that excluded patients (1) with chronic kidney disease, (2) with AKI not commenced renal replacement therapy (RRT), and (3) with estimated pre-admission creatinine, chronic kidney disease, or AKI stage 1. Conclusion: AKI was not an independent risk factor for 3-year mortality among 30-day survivors. Increased 3-year mortality among patients with AKI who survive critical illness may not be related to AKI per se, but rather to advanced age and pre-existing comorbidities.Peer reviewe
Costs and Cost-Utility of Critical Care and Subsequent Health Care: A Multicenter Prospective Study*
MOESM2 of Three-year mortality in 30-day survivors of critical care with acute kidney injury: data from the prospective observational FINNAKI study
Additional file 2: Figure S1. Distribution plot showing the frequency of confounders before and after matchingamong patients with and without acute kidney injury