Prognosis of ARF in hospitalized elderly patients

Prognosis of ARF in hospitalized elderly patients

Author Sesso, R. Google Scholar
Roque, A. Google Scholar
Vicioso, B. Google Scholar
Stella, S. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Univ Texas
Abstract Background: Differentiation between hospital-acquired acute renal failure (ARF) and community-acquired ARF may have epidemiological implications that lead to different prognoses in hospitalized patients. Such a comparison has not yet been made among elderly individuals. Methods: We performed a 3-year prospective study in a tertiary referral hospital of 325 patients aged 60 years or older who presented with ARF. Patients were divided into 2 groups; those with hospital-acquired ARF (n=154) and community-acquired ARF (n=171), and were followed up in relation to mortality. Multiple logistic regression was used in the analysis. Results: the overall mortality rate in this elderly population was 54%; 59% for the group with hospital-acquired ARF and 41% for the group with community-acquired ARF (P<0.001). Groups differed (P<0.01) in relation to cause of ARF, preexisting diseases, organ failure, sepsis, and performance of dialysis, among other factors. the adjusted mortality risk for the group with hospital-acquired ARF was 2.23 times greater than for the group with community-acquired ARF (95% confidence interval [CI], 1.21 to 4.08). in the group with hospital-acquired ARF, factors associated with mortality were neurological failure (odds ratio [OR], 2.97; 95% CI, 1.17 to 7.60), hematologic failure (OR, 4.30; 95% CI, 1.63 to 11.34), and oliguria (OR, 12.14; 95% CI, 4.62 to 31.87). in the group with community-acquired ARF, significant factors were neoplasia, cardiac disease, hepatic disease, cardiovascular failure, oliguria, and sepsis. Conclusion Differentiation between hospital-acquired ARF and community-acquired ARF is important in determining the prognosis of ARF in the elderly. Mortality risk factors are different in these 2 groups, and knowledge of their characteristics may allow better management of such patients.
Keywords acute renal failure (ARF)
hospital acquired
community acquired
Language English
Date 2004-09-01
Published in American Journal of Kidney Diseases. Philadelphia: W B Saunders Co, v. 44, n. 3, p. 410-419, 2004.
ISSN 0272-6386 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co
Extent 410-419
Access rights Closed access
Type Article
Web of Science ID WOS:000223648500003

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