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Table 3 Association of more severe (stage 2 or 3) AKI with PICU mortality using two different approaches for determination of bSCra

From: Acute kidney injury is an independent risk factor for pediatric intensive care unit mortality, longer length of stay and prolonged mechanical ventilation in critically ill children: a two-center retrospective cohort study

 

Standard bSCr determinations (AKINstandard bSCr)b

Normative values for bSCr in all patients (AKINall norms bSCr)b

Characteristics

Model 1c

Model 2c

Model 3c

Model 4c

AKIN stage 2 or 3

9.0 (5.4 to 15.0)d

5.8 (3.3 to 10.4)d

9.9 (5.8 to 16.7)d

6.4 (3.6 to 11.7)d

Age under one year

1.8 (1.1 to 2.9)d

1.0 (0.6 to 1.8)

1.9 (1.1 to 3.1)d

1.0 (0.6 to 1.8)

Female

0.7 (0.4 to 1.1)

0.7 (0.4 to 1.3)

0.6 (0.4 to 1.0)

0.7 (0.4 to 1.2)

CHUSJ site

0.7 (0.4 to 1.1)

0.7 (0.4 to 1.3)

0.6 (0.4 to 1.0)

0.7 (0.4 to 1.2)

PRISM score, tertiles

    

0 to 3 (reference

group)

-

1.0 (reference)

-

1.0 (reference)

   4 to 6

-

0.5 (0.2 to 1.4)

-

0.5 (0.2 to 1.5)

   > 6

-

2.6 (1.2 to 5.7)d

-

2.7 (1.3 to 5.9)d

Mechanical

ventilation

-

17.8 (6.3 to 50.4)d

-

19.2 (6.8 to 54.5)d

Postoperative

status

-

0.3 (0.1 to 0.7)d

-

0.3 (0.1 to 0.7)d

   bSCr

-

Droppede

-

Droppede

Documented

infection

-

2.3 (1.1 to 5.0)d

-

2.3 (1.1 to 5.0)d

  1. aAKI = acute kidney injury; AKIN = Acute Kidney Injury Network staging system; bSCr = baseline serum creatinine; CHUSJ = Centre Hospitalier Universitaire Ste-Justine; PICU = pediatric intensive care unit; PRISM = Pediatric Risk of Mortality; SCr = serum creatinine.
  2. All results are presented as odds ratios (95% CI). bStandard bSCr method on the left side of the table (or AKINstandard bSCr ) lists bSCr levels as the lowest SCr level in the three months prior to admission or normative values based on SCr for age and gender when there were no prior SCr data available. The right side of the table lists normative SCr values for age and gender, which were used to estimate bSCr values in all patients (AKINall norms bSCr) to determine the presence of AKI. cTwo different statistical models (or regression analyses) were performed (using stepwise backward multiple logistic regression analysis) to evaluate the independent effect of AKI on PICU mortality. Model 1 was used to evaluate the effect of AKI on PICU mortality, controlling only for age, gender and study site. Model 2 was used to evaluate the effect of AKI on PICU mortality, controlling for age, gender, study site, PRISM tertile, ventilation status, postoperative status, presence or absence of bSCr data and presence or absence of documented infection. dOdds ratios are statistically significant (P < 0.05). e"Dropped" means that in the backward stepwise multiple logistic regression analysis, that variable was not retained in the model and was not statistically significant.