Incidence, Risk Factors, and Outcome of Acute Kidney Injury in the Intensive Care Unit: A Single-Center Study from Jordan

Oweis, Ashraf O; Alshelleh, Sameeha A; Momany, Suleiman; Samrah, Shaher; Khassawneh, Basheer; Ali, Musa A. K. Al

doi:10.1155/2020/8753764

Cited by 17 publications

(12 citation statements)

References 39 publications

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“…In accordance with previous published studies, LOS is higher in patients receiving RRT [20,21,25], but reports about length of ICU stay in relation to the main organ dysfunction at admission are extremely limited. We noted that multiple trauma and surgical patients, or patients with renal and gastrointestinal dysfunction that needed RRT, had a greater risk of increased ICU stay compared with those without this intervention.…”

Section: Discussionsupporting

confidence: 90%

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Overview of Renal Replacement Therapy Use in a General Intensive Care Unit

Ţigliş

Peride

Florea

et al. 2022

IJERPH

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Objectives. Population-based studies regarding renal replacement therapy (RRT) used in critical care populations are useful to understand the trend and impact of medical care interventions. We describe the use of RRT and associated outcomes (mortality and length of intensive care stay) in a level 1 hospital. Design. A retrospective descriptive observational study. Patients. Critically ill patients admitted to the ICU from 1 January to 31 December 2018. Interventions. Age, gender, ward of admission, primary organ dysfunction at admission, length of hospital stay (LOS), mechanical ventilation, APACHE, SOFA and ISS scores, the use of vasopressors, transfusion, RRT and the number of RRT sessions were extracted. Results. 1703 critically ill patients were divided into two groups: the RRT-group (238 patients) and the non-RRT group (1465 patients). The mean age was 63.58 ± 17.52 (SD) in the final ICU studied patients (64.72 ± 16.64 SD in the RRT-group), 60.5% being male. Patients admitted from general surgery ward needing RRT were 41.4%. The specific scores, the use of vasopressors, transfusions and mortality were higher in the RRT-group. The ICU LOS was superior in the RRT-group, regardless of the primary organ dysfunction. Conclusions. RRT was practiced in 13.9% of patients (especially after age of 61), with mortality being the outcome for 66.8% of the RRT-group patients. All analyzed data were higher in the RRT group, especially for multiple trauma and surgical patients, or patients presenting cardiac or renal dysfunctions at admission. We found significant increased ISS scores in the RRT-group, a significant association between the need of vasopressors or transfusion requirement and RRT use, and an association in the number of RRT sessions and LOS (p < 0.001).

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Section: Discussionsupporting

confidence: 90%

“…The overall RRT need during ICU stay was 13.9% in our study. Others reported an incidence of 8.3%, Paccinni et al [18], 8.8%, Fujii et al [19], 12%, Harris et al [20], and 20.4% was found by Oweis et al [21]. The differences most likely result from the profile of each intensive therapy, the presented one being a general ICU unit.…”

Section: Discussionmentioning

confidence: 95%

Overview of Renal Replacement Therapy Use in a General Intensive Care Unit

Ţigliş

Peride

Florea

et al. 2022

IJERPH

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“…Association of AKI with mortality, morbidity, CKD, and prolonged hospitalization especially in critically ill patients and patients admitted to ICU is well documented in the literature, which reflects the worldwide importance of early detection and prevention with the aim of decreasing death and morbidity. [17][18][19][20][21] A systemic review done by Almashrafi et al 22 shows association of increased age, atrial fibrillation and renal dysfunction with prolonged ICU LOS.A similar study done by Atoui R 23 on 426 patients shows significant associations of ejection fraction <40% (p=0.04), and history of renal failure (p=0.001).Whereas, a locally conducted study in our region showed some benefit of tight glycemic control(in pre and post CABG patients) on the length of ICU stay. 24 The percentage of patients with prolonged ICU stay in on pump surgeries (66.7%) was found to be much higher than in off pump surgeries (28.1%).…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with prolonged intensive care unit stay in post coronary artery bypass grafting patients with chronic kidney disease

Syeda¹,

Saleem²,

Rasool³

et al. 2023

Pak J Med Sci

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Objective: Prolonged intensive care unit stay not only increases hospital cost but it also prevents hospital equipment to be used by other patients who need them. The aim of this study was to identify factors that affect the duration of intensive care unit stay in post coronary artery bypass grafting patients with chronic kidney disease. Method: This is a single centered observational prospective study done on 191 post coronary artery bypass grafting patients from June 2018 to April 2019 at Cardiac Surgery Unit of Doctor’s hospital and medical center, Lahore, Pakistan. Patients above 18 years with and without chronic kidney disease were included. Results: Mean age of the patients was 57.83 years (± 9.862 SD. Logistic regression analysis shows that patients with post op arrhythmias had the strongest positive association with prolonged intensive care unit stay (OR:11; p value :<0.01), followed by recent myocardial infarction less than 90 days pre coronary artery bypass grafting (OR:5.93; p value:<0.01), shock (OR:3.93;p value:0.04) and acute kidney injury (OR :2.08;p value:0.04). 37.5% chronic kidney disease patients with recent myocardial infarction less than 90 days pre coronary artery bypass grafting and 51.4% patients of chronic kidney disease found with acute kidney injury, showed significant association with p values less than 0.05. Conclusion: Post op arrhythmias, recent myocardial infarction, shock and acute kidney injury are independent risk factors causing prolonged intensive care unit stay in post coronary artery bypass grafting patients. doi: https://doi.org/10.12669/pjms.39.2.6735 How to cite this: Zartash SH, Saleem S, Rasool Z, Mansur A. Risk factors associated with prolonged intensive care unit stay in post coronary artery bypass grafting patients with chronic kidney disease. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.6735 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…In the Jordanian population, it reached up to 31.6%. 6 Factors that affect the outcome of these patients with AKI in ICU settings include volume overload, sepsis, and the need for RRT. All of which can increase the hospital stay, the recurrence of AKI, the development of chronic kidney disease (CKD), and the rate of in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

“…AKI can be classified through different criteria, 4,5 and the incidence can be as low as 2% to as high as 92% in hospitalized patients. 6 Identifying risk factors and patients at risk for AKI related to MDR infection will help treating physicians develop preventive and treatment protocols for AKI and may lower mortality in those patients. Therefore, in the present study, the risk for Multidrug-resistant (MDR) infections and its effect on the incidence of AKI, hospitalization, need for dialysis, and mortality was evaluated.…”

Section: Introductionmentioning

confidence: 99%

Acute Kidney Injury Among Patients with Multi-Drug Resistant Infection: A Study from Jordan

Oweis¹,

Zeyad²,

Alshelleh³

et al. 2022

JMDH

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Background: Acute kidney injury (AKI) is a well-known complication for hospitalized patients. Sepsis and various infections play a significant role in increasing the incidence of AKI. The present study evaluated the risk for Multidrug-resistant (MDR) infections and its effect on the incidence of AKI, hospitalization, need for dialysis, and mortality. Methods: In a retrospective study design, data were collected from all adult patients with a positive multi-drug resistant culture who were admitted to King Abdullah University Hospital (KAUH). Records of 436 patients were reviewed between January 2017 -December 2018 with at least one year of follow-up. Results: The mean age was 57.3 years (SD± 23.1), and 58.5% were males. The most common source of positive cultures was sputum, with 50% positive cultures. The incidence of AKI was 59.2%. The most isolated microorganism was Acinetobacter baumannii (76.8%), followed by Pseudomonas aeruginosa (14.9%).On multivariate analysis, age (OR 1.1, 95% CI 1.1-1.2, P=0.001), HTN (OR 1.8, 95% CI 1.0-3.3, P=0.02), DM (OR 1.1, 95% CI 0.6-1.9, P=0.69) and the use of Foley catheter on chronic bases (OR 4.3, 95% CI 2.6-6.8, P<0.0001) were strong predictors of AKI. Among patients with AKI, 74.4% died compared to 44.4% among non-AKI patients (p<0.001). Conclusion:In patients with MDR, AKI incidence, hospitalization, and mortality were high. Early detection and addressing the problem may decrease bad outcomes, and health education for reducing antibiotic abuse is needed to lower MDR.

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Incidence, Risk Factors, and Outcome of Acute Kidney Injury in the Intensive Care Unit: A Single-Center Study from Jordan

Cited by 17 publications

References 39 publications

Overview of Renal Replacement Therapy Use in a General Intensive Care Unit

Overview of Renal Replacement Therapy Use in a General Intensive Care Unit

Risk factors associated with prolonged intensive care unit stay in post coronary artery bypass grafting patients with chronic kidney disease

Acute Kidney Injury Among Patients with Multi-Drug Resistant Infection: A Study from Jordan

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