multiple-center evaluation of mortality associated with acute kidney injury in critically ill patients a competing risks analysismultiple-center评估危重患者的死亡率与急性肾损伤相关竞争风险分析.pdfVIP
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multiple-center evaluation of mortality associated with acute kidney injury in critically ill patients a competing risks analysismultiple-center评估危重患者的死亡率与急性肾损伤相关竞争风险分析
Clec’h et al. Critical Care 2011, 15:R128
/content/15/3/R128
RESEARCH Open Access
Multiple-center evaluation of mortality associated
with acute kidney injury in critically ill patients: a
competing risks analysis
1,2* 1 3 2 2,4
Christophe Clec’h , Frédéric Gonzalez , Alexandre Lautrette , Molière Nguile-Makao , Maïté Garrouste-Orgeas ,
5 6 7 1 8
Samir Jamali , Dany Golgran-Toledano , Adrien Descorps-Declere , Frank Chemouni , Rebecca Hamidfar-Roy ,
Elie Azoulay2,9 and Jean-François Timsit2,8
Abstract
Introduction: In this study, we aimed to assess the association between acute kidney injury (AKI) and mortality in
critically ill patients using an original competing risks approach.
Methods: Unselected patients admitted between 1997 and 2009 to 13 French medical or surgical intensive care
units were included in this observational cohort study. AKI was defined according to the RIFLE criteria. The
following data were recorded: baseline characteristics, daily serum creatinine level, daily Sequential Organ Failure
Assessment (SOFA) score, vital status at hospital discharge and length of hospital stay. Patients were classified
according to the maximum RIFLE class reached during their ICU stay. The association of AKI with hospital mortality
with “discharge alive” considered as a competing event was assessed according to the Fine and Gray model.
Results: Of the 8,639 study patients, 32.9% had AKI, of whom 19.1% received renal replacement therapy. Patients
with AKI had higher crude mortality rates and longer lengths of hospital stay th
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