Early and small changes in serum creatinine concentrations are associated with mortality in mechanically ventilated patients

Shock
Nicolás NinVENTILA Group

Abstract

Emerging evidence suggests that minor changes in serum creatinine concentrations are associated with increased hospital mortality rates. However, whether serum creatinine concentration (SCr) on admission and its change are associated with an increased mortality rate in mechanically ventilated patients is not known. We have conducted an international, prospective, observational cohort study enrolling adult intensive care unit patients under mechanical ventilation (MV). Recursive partitioning was used to determine the values of SCr at the start of MV (SCr0) and the change in SCr ([DeltaSCr] defined as the maximal difference between the value at start of MV [day 0] and the value on MV day 2 at 8:00 am) that best discriminate mortality. In-hospital mortality, adjusted by a proportional hazards model, was the primary outcome variable. A total of 2,807 patients were included; median age was 59 years and median Simplified Acute Physiology Score II was 44. All-cause in-hospital mortality was 44%. The variable that best discriminated outcome was a SCr0 greater than 1.40 mg/dL (mortality, 57% vs. 36% for patients with SCr0 <or=1.40 mg/dL, P < 0.001). Among patients with SCr0 less than or equal to 1.40 mg/dL, DeltaSCr greater than 0.31 di...Continue Reading

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Citations

Apr 8, 2011·American Journal of Respiratory and Critical Care Medicine·Frédérique Schortgen, Laurent Brochard
Jan 16, 2014·Journal of Nephrology·Abraham OteroJosé A Lorente
Jun 2, 2014·Medicina intensiva·M SeijasJ A Lorente
Oct 1, 2013·Clinical Nephrology·Francis Perry WilsonBarry D Fuchs
Mar 23, 2012·Medicina intensiva·P Cardinal-FernándezJ A Lorente
Jun 15, 2016·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Emilio RodrigoManuel Arias
Nov 2, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Xiaoxi ZengSushrut S Waikar
Jun 28, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Raúl LombardiUNKNOWN VENTILA Group
Sep 25, 2019·Annals of Intensive Care·Stephan EhrmannUNKNOWN Clinical research in intensive care and sepsis-Trial group for global evaluation and research in sepsis (CRICS-TRIGGERSEP ne
Jul 16, 2014·Clinical Trials : Journal of the Society for Clinical Trials·Francis Perry WilsonBarry Fuchs
May 7, 2020·The Aging Male : the Official Journal of the International Society for the Study of the Aging Male·Mehmet Can ErAli Haydar Sahinoglu

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