Volume 5 Supplement 1

21st International Symposium on Intensive Care and Emergency Medicine

Open Access

ICU acquired acute renal failure carries a higher mortality than acute renal failure on admission to ICU

  • M Ostermann1,
  • S Nelson1 and
  • R Chang1
Critical Care20015(Suppl 1):P222

DOI: 10.1186/cc1289

Received: 15 January 2001

Published: 2 March 2001

Acute renal failure (ARF) has a significant impact on outcome of critically ill patients [1]. The aim of this study was to identify any differences between patients with ARF on admission to the intensive care unit (ICU) and patients developing ARF during their stay in the ICU. We retrospectively analysed data from The Riyadh Intensive Care Program (RIP) database which contains demographic data of 26,669 patients admitted to 21 ICUs in the United Kingdom (UK) during the time period June 1989 until September 1996. ARF was defined according to the organ system failure scoring system by Knaus et al [2]. Patients with chronic renal failure were excluded.

Comment

Our study confirms that ARF increases mortality in ICU patients with a further marked increase amongst patients who require renal replacement therapy (RRT). Patients who develop ARF during their stay in the ICU have a significantly worse outcome compared to patients with ARF on admission to ICU.

Table 1

 

Total

All patients with ARF

ARF on admission to ICU

ARF during stay in ICU

Number of patients

26 669 (100%)

2395 (9.0%)

1394 (5.2%)

1001 (3.8%)

Female:male

1 : 1.7

1 : 1.9

1 : 1.8

1 : 2.1

Mean age (SD)

59.1 (17.4)

59.7 (17.3)

59.6 (17.7)

59.7 (16.9)

APACHE II score on admission (SD)

12.9 (8.3)

19.7 (9.5)

20.97 (7.2)

17.8 (6.4) *

APACHE II score on day of ARF (SD)

N/A

N/A

20.97 (7.2)

23.1 (7.3) *

Mean length of stay in ICU (days)

3.9

8.0

8.7

7.2

Need for RRT (%)

769 (2.9%)

769 (32.1%)

384 (27.5%)

385 (38.5%) *

Mean duration of RRT (days)

N/A

2.1

1.7

2.7

Hospital mortality of patients on RRT

505 (65.7%)

505 (65.7%)

241 (62.8%)

264 (68.6%) *

Hospital mortality

6633 (25%)

1340 (56%)

734 (52.7%)

606 (60.5%) *

*P < 0.001 (comparison between ARF on admission to ICU and ARF during stay in ICU); N/A = not applicable; SD = standard deviation.

Authors’ Affiliations

(1)
Department of Nephrology, St George's Hospital

References

  1. Levy EM, Viscoli CM, Horwitz RI: The effect of acute renal failure on mortality - a cohort analysis. JAMA 1996, 275: 1489-1494. 10.1001/jama.275.19.1489View ArticleGoogle Scholar
  2. Knaus WA, Draper EA, Wagner DP, Zimmermann JE: Prognosis in acute organ-system failure. Am Surg 1985, 202: 685-693.Google Scholar

Copyright

© The Author(s) 2001

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