Evaluation of prognostic indexes in critical acute renal failure patients

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dc.contributor.authorBatista, PBP
dc.contributor.authorNeto, M. C.
dc.contributor.authorSantos, OFP dos
dc.contributor.authorBacelar, ACC
dc.contributor.authorCampos, G. B.
dc.contributor.authorSantos, ESC dos
dc.contributor.institutionSao Rafael Hosp
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T12:34:13Z
dc.date.available2016-01-24T12:34:13Z
dc.date.issued2004-01-01
dc.description.abstractObjective. To study different prognostic indexes in acute renal failure (ARF) patients admitted to an intensive care unit (ICU). Design. Prospective, cohort study. Individual Severity Score-Acute Tubular Necrosis (ISS-ATN) obtained prospectively and retrospectively, Acute Physiologic and Chronic Health Evaluation (APACHE II) Score, APACHE II Risk, Lung Injury Score (LIS), and Number of Organ Failures (NOF) were calculated for each patient. the outcome analyzed was death in the ICU. Discrimination was evaluated by the area under the receiver operator characteristic curve (AUC). for calibration analysis, the chi-square goodness-of-fit test was used to compare predicted mortality, calculated by ISS-ATN (obtained prospectively or retrospectively) and APACHE II risk, with observed mortality. Setting. ICU, Sao Rafael Hospital, Salvador-BA, Brazil. Patients. Seventy-six ARF patients admitted to the ICU within 6 months. Interventions. Surgical and medical procedures. Measurements and Results. the observed AUC was 0.69 for LIS, 0.73 for prospective ISS-ATN, 0.75 for retrospective ISS-ATN, 0.76 for APACHE II Score, 0.78 for APACHE II Risk, and 0.88 for NOF. These areas were significantly different from 0.5 (p <.001). There was no difference between the observed and expected death rate calculated by ISS-ATN. However, APACHE II underestimated the observed mortality (p <.001). Conclusion. the prognostic indexes studied showed good discriminative power. However, APACHE II was not well calibrated in contrast to the good calibration of ISS-ATN.en
dc.description.affiliationSao Rafael Hosp, Nephrol & Hemodialysis Serv, BR-40296720 Salvador, BA, Brazil
dc.description.affiliationSao Rafael Hosp, Intens Care Unit, BR-40296720 Salvador, BA, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, Dept Med, Div Nephrol, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, Dept Med, Div Nephrol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent545-552
dc.identifierhttp://dx.doi.org/10.1081/JDI-200031755
dc.identifier.citationRenal Failure. New York: Marcel Dekker Inc, v. 26, n. 5, p. 545-552, 2004.
dc.identifier.doi10.1081/JDI-200031755
dc.identifier.issn0886-022X
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/27558
dc.identifier.wosWOS:000224501400010
dc.language.isoeng
dc.publisherMarcel Dekker Inc
dc.relation.ispartofRenal Failure
dc.rightsAcesso restrito
dc.subjectacute renal failureen
dc.subjectcalibrationen
dc.subjectdiscriminationen
dc.subjectmortalityen
dc.subjectprognosisen
dc.subjectROC curveen
dc.subjectAPACHE (Acute Physiologic and chronic health evaluation) IIen
dc.subjectcreatinineen
dc.subjectdialysisen
dc.subjectdiuresisen
dc.subjectintensive care uniten
dc.subjectlung injury scoreen
dc.subjectprognostic indexen
dc.subjectrespiratory failureen
dc.subjectpositive end expiratory pressure (PEEP)en
dc.subjectdeath rateen
dc.titleEvaluation of prognostic indexes in critical acute renal failure patientsen
dc.typeArtigo
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