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  • Meeting abstract
  • Open Access

Secular trends in the survival of patients with dialytic acute renal failure (ARF) in an intensive care unit (ICU)

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Critical Care20015 (Suppl 3) :P35

https://doi.org/10.1186/cc1368

  • Published:

Keywords

  • Public Health
  • Mortality Rate
  • Intensive Care Unit
  • Renal Failure
  • Emergency Medicine
In 1997, we started performing CVVH/HD in our ICU, which allowed us to improve the metabolic control of our dialysis patients. We sought to investigate the trends in mortality rates of ARF patients treated in our ICU from January 1992 to December 1998. The APACHEII score and risk of death of all patients (n = 10723, age 61 ± 18 years, 62% males) and of patients with ARF submitted to dialysis therapies (n = 256, age 61 ± 18 years, 70% males) are shown in the Table.

Table

 

1992

1993

1994

1995

1996

1997

1998

Patients with dialytic ARF

34

22

27

39

38

55

41

APACHE II score

24.5

25.9

27.6

25.9

26.6

25.4

24.7

Risk of death (%)

45

51.2

52.4

47.1

53.3

43.7

44.7

ICU mortality (%)

67.6

59.1

66.7

53.8

63.2

52.7

42.5

All patients

1343

1432

1428

1545

1691

1589

1695

APACHE II score

13.7

13.3

14.3

14.3

14

14.3

11.3

Risk of death (%)

19.7

18.7

19.3

19.3

19.3

20.3

14.7

ICU mortality (%)

11.3

11.3

10.7

10

9.3

9.3

8

In 1998, for the first time, the mortality in the ARF population was lower than the expected mortality (risk of death). Comparing the 1992-1996 period with 1997-1998, there was no reduction in the expected mortality (49% versus 44%; P = 0.46), but there was a significant reduction in the ICU mortality (62% versus 48%; P = 0.04). This improvement in survival could be due to an overall improvement in our standards of care or in the dialytic therapy.

Authors’ Affiliations

(1)
Centro de Terapia Intensiva, Hospital Israelita Albert Einstein, São Paulo, Brazil

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