Lesión renal aguda en niños críticos

Manotas, Hernán; Ibarra, Milton; Arteaga, Ángela; Romero, Andrés; Sanchez, Jorge

doi:10.1016/j.acci.2018.06.003

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…The results obtained in our cohort revealed an incidence of AKI of 12.5 per 100 patients, a gure that is similar to the ndings of other studies conducted locally in Medellin and in Colombia, which report an incidence ranging from 11.5-41.1% [24][25][26][27][28][29]. The AWARE study reports an incidence of AKI in pediatric patients of 11% [30].…”

Section: Discussionsupporting

confidence: 88%

Evaluation of the Utility of the Renal Angina Index for the Early Diagnosis of Severe Acute Kidney Injury in Critically Ill Pediatric Patients in Three Institutions in Low-Resource Country

Flórez,

Bernal,

Piñeres-Olave

et al. 2024

Preprint

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Background: Acute kidney injury (AKI) occurring in up to 30% of children admitted to the intensive care unit. Creatinine is the primary functional marker for AKI; however, its utility in early diagnosis is limited. The renal angina index (RAI) has proven to be an effective predictive model for early injury, with limited evidence in Colombia regarding its performance. Methods: Prospective, analytical, multicenter diagnostic test study in critically ill children in three pediatric intensive care units (PICUs) in Medellín, Colombia. We assess the diagnostic utility of the positive RAI as an early predictor of severe AKI. Results: Between August 2022 and February 2023, 191 patients were analyzed. The incidence of AKI was 12.5/100 patients, 26% exhibited a positive RAI, 12.6% developed severe AKI at 72 hours. Among RAI-positive patients when comparing with negative, 75% experienced severe AKI (RR 3.23; 95% CI 1.61-6.49), 14% required renal support therapy (RR 2.09; 95% CI 0.95-4.59), and 8% died within 28 days (p=0.964). The sensitivity of RAI for early diagnosis of severe AKI was 85.71%, specificity 78.3%, PPV 24%, NPV 98.5%, AUC 0.812 (95% CI 0.72-0.92). To the patients with a doubled baseline creatinine, 33% developed AKI at 72 hours (RR 1.45; 95% CI 1.09-1.92). Conclusions: The RAI proved to be a marker for early prediction of severe AKI in critically ill children, potentially serving as a useful tool to improve outcomes related to the presence of AKI compared to the isolated use of creatinine.

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Section: Discussionsupporting

confidence: 88%

Evaluation of the Utility of the Renal Angina Index for the Early Diagnosis of Severe Acute Kidney Injury in Critically Ill Pediatric Patients in Three Institutions in Low-Resource Country

Flórez,

Bernal,

Piñeres-Olave

et al. 2024

Preprint

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“…Many authors have reported that PRISM III overestimates ( 27 ) mortality and fails to have good calibration and discrimination in specific populations. ( 28 - 30 )…”

Section: Discussionmentioning

confidence: 99%

Performance of PRISM III and PIM 2 scores in a cancer pediatric intensive care unit

Farias¹,

Mello²,

Assunção³

et al. 2021

Crit Care Sci

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“…A população estudada apresentou distribuição por faixa etária semelhante às demais séries 16,17,18,19,20,21 . Em relação ao diagnóstico admissional, foram observadas divergências nos achados em relação a outros estudos 17,22,23,24,25,26 ; nesses, os principais diagnósticos foram doenças respiratórias e neurológicas, enquanto que, neste estudo, as principais doenças foram infecciosas, seguidas de doenças respiratórias e neurológicas.…”

Section: /9unclassified

“…Muitos autores relataram que o escore PRISM superestima 3,16,17,18 a mortalidade e que não apresenta boa calibração e discriminação em populações específicas 19,20,21 . No presente estudo, o PRISM apresentou boa capacidade de calibração e discriminação, apesar de ter subestimado a mortalidade, corroborando com outros estudos 19,20,21,27,28,29,30 .…”

Section: /9unclassified

Desempenho do Pediatric Risk of Mortality (PRISM) e Pediatric Index of Mortality 2 (PIM2) em unidade de terapia intensiva pediátrica terciária na Amazônia brasileira

Farias¹,

Carvalho²,

Nascimento³

et al. 2019

Revista Pan-Amazônica de Saúde

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RESUMO OBJETIVO: Avaliar o desempenho dos escores de mortalidade Pediatric Risk of Mortality (PRISM) e Pediatric Index of Mortality 2 (PIM2) na Unidade de Terapia Intensiva Pediátrica (UTIP) Terciária da Fundação Santa Casa de Misericórdia do Pará (FSCMPA). MATERIAIS E MÉTODOS: Estudo de coorte retrospectivo, incluindo pacientes admitidos na UTIP, entre janeiro de 2017 a abril de 2018, com permanência por mais de 8 h. Os critérios de exclusão foram: permanência superior a 90 dias; parada cardiorrespiratória sem estabilidade em 12 h; cuidados paliativos; e morte encefálica. Para calcular os sistemas de escores e desfecho, utilizou-se as variáveis Standardized Mortality Rate (SMR), calibração e discriminação, que foram comparadas pelos testes goodness-of-fit e curvas Receiver Operating Characteristic (ROC), respectivamente. RESULTADOS: Entre as 458 internações, 429 (93,7%) foram incluídas. A mortalidade geral foi de 17,5%, sendo que 64,0% eram menores de 2 anos de idade e 58,7% dos que evoluíram a óbito foram submetidos à ventilação mecânica por período maior que sete dias. A média de probabilidade de morte estimada do PRISM foi 9,85%, enquanto a média do PIM2 foi de 14,2%. O SMR foi de 1,35 (1,26-1,72) para o PRISM e de 1,23 (1,13-1,58) para o PIM2. A área sob a curva ROC foi de 0,89 (IC 95% 0,81-0,91) para o PRISM e 0,87 (IC 95% 0,83-0,91) para o PIM2. CONCLUSÃO: Na UTIP da FSCMPA, o PRISM e o PIM2 tiveram boa calibração e bom poder discriminatório. O SMR foi superior a um.ABSTRACT OBJECTIVE: To evaluate the performance of the Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality 2 (PIM2) scores in the Tertiary Pediatric Intensive Care Unit (PICU) of the Fundação Santa Casa de Misericórdia do Pará (FSCMPA). MATERIALS AND METHODS: A retrospective cohort study was conducted with patients hospitalized in PICU for more than 8 h, from January 2017 to April 2018. Exclusion criteria were: stay longer than 90 days; cardiorespiratory arrest without stability in 12 h; palliative care; and brain death. To calculate score and outcome systems, Standardized Mortality Rate (SMR), calibration, and discrimination variables were used and compared by goodness-of-fit and Receiver Operating Characteristic (ROC) curves, respectively. RESULTS: Among the 458 hospitalizations, 429 (93.7%) were included. Overall mortality was 17.5%, with 64.0% under 2 years of age; and 58.7% of those who evolved to death were submitted to mechanical ventilation for more than seven days. The estimated mean probability of death from PRISM was 9.85%, while the mean PIM2 was 14.2%. The SMR was 1.35 (1.26-1.72) for PRISM and 1.23 (1.13-1.58) for PIM2. The area under the ROC curve was 0.89 (95% CI 0.81-0.91) for PRISM and 0.87 (95% CI 0.83-0.91) for PIM2. CONCLUSION: In the FSCMPA PICU, PRISM and PIM2 had good calibration and good discriminatory power. The SMR was greater than one.

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Lesión renal aguda en niños críticos

Cited by 4 publications

References 24 publications

Evaluation of the Utility of the Renal Angina Index for the Early Diagnosis of Severe Acute Kidney Injury in Critically Ill Pediatric Patients in Three Institutions in Low-Resource Country

Evaluation of the Utility of the Renal Angina Index for the Early Diagnosis of Severe Acute Kidney Injury in Critically Ill Pediatric Patients in Three Institutions in Low-Resource Country

Performance of PRISM III and PIM 2 scores in a cancer pediatric intensive care unit

Desempenho do Pediatric Risk of Mortality (PRISM) e Pediatric Index of Mortality 2 (PIM2) em unidade de terapia intensiva pediátrica terciária na Amazônia brasileira

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