Evaluation of Prevalence and Causes of Acute Kidney Injury and its Effect on Short Time Mortality in Intensive Care Unit Patients OC10-OC12
Dr. Fereidun Khaje ali,
Internal Medicine Department, Hajar Hospital, Shahrekord, Iran.
Introduction: Hospital mortality of Intensive Care Unit (ICU) patients has shown correlation with severity of the Acute Kidney Injury (AKI). There are a few studies regarding short term or long term morbidity and mortality of the ICU patients after hospital discharge.
Aim: The aim of the study was to evaluate predisposing factors, in hospital mortality and six months followup of the ICU admitted patients in two general hospitals.
Materials and Methods: This prospective descriptive study was carried out on 520 ICU admitted patients, in Hajar and Kashani Hospitals, Shahrekord, Iran. The patients were evaluated for causes of hospital admission and inpatient and outpatient mortalities three and six months after discharge. Data were collected and analyzed by SPSS version 19.0 through Spearman’s and Pearson’s correlation tests.
Results: Of 520 patients under study, 350 were male and others were female. Mean age of the patients was 55.06±23.3 years. During ICU admission, AKI developed in 147 (28.2%) patients. Based on RIFLE criteria, in the patients with AKI, prevalence of risk, injury and failure were 51 (35%), 44 (30%) and 52 (35%) patients respectively. In the patients older than 65, AKI was more common (p=0.03). In the patients with AKI compared to other patients, serum sodium (Na), Potassium (K), was higher but haemoglobin and platelet were significantly lower. During ICU admission 91 (17.5%) patients died, out of which 56 (38%) cases had AKI and 35 (9.3%) had not (p<0.001). Among dead patients, prevalence of risk, injury and failure were 16%, 30.3% and 53.5% respectively. Among the alive patients, after hospital discharge, 3 months survival were 55.1%, 54.9%, 46.8% and 68.9% in risk, injury, failure and non AKI groups respectively (p=0.002), however six months survival of the AKI patients were 54.7%, 46.3% and 24.9% in risk, injury and failure patients comparing to 69.2% in non AKI patients respectively (p=0.001).
Conclusion: The study showed that inpatient mortality and short term survival of the ICU admitted patients had correlation with severity of AKI, based on RIFLE criteria. So, proper prophylaxis and treatment methods for prevention of AKI are very important and critical in these patients.