Short, and long-term mortality among cardiac intensive care unit patients started on continuous renal replacement therapy

Keleshian, Vasken; Kashani, Kianoush; Kompotiatis, Panagiotis; Barsness, Gregory W.; Jentzer, Jacob C.

doi:10.1016/j.jcrc.2019.11.001

Cited by 21 publications

(13 citation statements)

References 36 publications

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“…The characteristics of the included studies are presented in Table 1. Two of the six included studies were designed as prospective studies [20,21], and the other four were retrospective studies [22][23][24][25]. This systematic review comprises 1190 patients from the six studies, 744 males and 446 females.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Factors Associated with In-Hospital Mortality after Continuous Renal Replacement Therapy for Critically Ill Patients: A Systematic Review and Meta-Analysis

Lee

Son

2020

IJERPH

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Continuous renal replacement therapy (CRRT) is a broadly-accepted treatment for critically ill patients with acute kidney injury to optimize fluid and electrolyte management. Despite intensive dialysis care, there is a high mortality rate among these patients. There is uncertainty regarding the factors associated with in-hospital mortality among patients requiring CRRT. This review evaluates how various risk factors influence the in-hospital mortality of critically ill patients who require CRRT. Five databases were surveyed to gather relevant publications up to 30 June 2020. We identified 752 works, of which we retrieved 38 in full text. Finally, six cohort studies that evaluated 1190 patients were eligible. The in-hospital mortality rate in these studies ranged from 38.6 to 62.4%. Our meta-analysis results showed that older age, lower body mass index, higher APACHE II and SOFA scores, lower systolic and diastolic blood pressure, decreased serum creatinine level, and increased serum sodium level were significantly associated with increased in-hospital mortality in critically ill patients who received CRRT. These results suggest that there are multiple modifiable factors that influence the risk of in-hospital mortality in critically ill patients undergoing CRRT. Further, healthcare professionals should take more care when CRRT is performed on older adults.

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Factors Associated with In-Hospital Mortality after Continuous Renal Replacement Therapy for Critically Ill Patients: A Systematic Review and Meta-Analysis

Lee

Son

2020

IJERPH

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“… 39 There is mounting studies that have shown that the provision of RRT is associated with poor outcomes among CICU patients, with hospital mortality rates of at least 40% to 50% and 1-year mortality >70%. 40 , 41 These results can partially explain that elevated NPAR was associated to significantly increase mortality and the need for RRT in CICU patients.…”

Section: Discussionmentioning

confidence: 93%

Association Between the Neutrophil Percentage-to-Albumin Ratio and Outcomes in Cardiac Intensive Care Unit Patients

Wang¹,

Wang²,

Wu³

et al. 2021

IJGM

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Background The neutrophil percentage-to-albumin ratio (NPAR) is a systemic inflammation-based predictor associated with many diseases’ outcomes. Nevertheless, there are few studies on the relationship between NPAR and inflammatory markers, and more importantly, the prognostic value of NPAR in critically ill patients with cardiovascular disease (CVD) remains unknown. Methods The data of this retrospective cohort study were from the Medical Information Mart data for Intensive Care III database (MIMIC-III) and the Second Affiliated Hospital of Wenzhou Medical University. Linear regression, logistic regression model, and Cox regression model were used to assess the associations between NPAR levels and length of stay, renal replacement therapy (RRT) use, and 30-day, 90-day and one-year mortality, respectively. The Pearson correlation coefficient was used to present the correlation between NPAR and C-reactive protein (CRP). Results Our study included 1599 patients in MIMIC-III and 143 patients in the Second Affiliated Hospital of Wenzhou Medical University. The elevated NPAR was independently associated with increased 30-day, 90-day, and one-year all-cause mortality (adjusted HR, 95% CI:1.51 (1.02–2.24); 1.61 (1.14–2.28); 1.53 (1.15–2.03); P trend = 0.0297; 0.0053; 0.0023; respectively), and it was also associated with increase the length of stay in hospital and ICU (β, 95% CI: 2.76 (1.26–4.27); 1.54 (0.62–2.47), respectively, both P trend <0.001). We found that patients with higher NPAR were more likely to receive RRT (OR, 95% CI: 2.50 (1.28–4.89), P trend =0.0023). Moreover, we confirmed that NPAR was statistically positively correlated with CRP (correlation coefficient r = 0.406, P < 0.0001). Conclusion Elevated NPAR on admission was independently associated with increased all-cause mortality and length of stay among CICU patients. The results showed that CICU patients with higher NPAR were more likely to receive RRT. Besides, we also provided the evidence that there is a positive correlation between NPAR and inflammatory indicators (ie, CRP).

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“…Severe (i.e., stage 3) AKI drove most of the relationship between AKI and hospital mortality in our study, particularly for patients requiring dialysis. The need for dialysis in the setting of AKI has been associated with higher in‐hospital and post‐discharge morbidity and mortality among hospitalized patients with cardiovascular disease 2,34 …”

Section: Discussionmentioning

confidence: 99%

Incidence and outcomes of acute kidney injury stratified by cardiogenic shock severity

Padkins

Breen

Diepen

et al. 2021

Cathet Cardio Intervent

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Background Acute kidney injury (AKI) is common among patients with cardiogenic shock (CS) and it is independently associated with mortality. We sought to assess the prevalence, severity, and prognosis of AKI as a function of cardiogenic shock severity in unselected Cardiac Intensive Care Unit (CICU) patients. Methods We retrospectively reviewed admissions to the Mayo Clinic between 2007 to 2015 and stratified patients by the AKI stage (based on modified Kidney Disease: Improving Global Outcomes criteria) and Society for cardiovascular angiography and interventions (SCAI) shock stage. The association with in‐hospital mortality was analyzed using multivariable logistic regression. Results We included 9,311 unique patients with a mean age of 67 years and 37% females. SCAI shock stages A, B, C, D, and E were present in 47%, 30%, 15%, 7%, and 1% of patients. The incidence of AKI of any severity was 39% in the CICU and 51% during the hospitalization. Hospital mortality occurred in 8% of all patients, and the risk increased as a function of the rising AKI and SCAI shock stage. Worsening AKI stage was associated with increased adjusted hospital mortality (adjusted OR per AKI stage 1.22, 95% CI 1.10–1.36, p < .001). Higher AKI stages were associated with increased adjusted hospital mortality in SCAI stage A/B (p < .001), but not in SCAI stage C, D, or E (all p > .05). Conclusions Higher AKI stages were independently associated with mortality in CICU patients after accounting for shock severity and may add incremental prognostic utility in patients with lower SCAI stages.

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Short, and long-term mortality among cardiac intensive care unit patients started on continuous renal replacement therapy

Cited by 21 publications

References 36 publications

Factors Associated with In-Hospital Mortality after Continuous Renal Replacement Therapy for Critically Ill Patients: A Systematic Review and Meta-Analysis

Factors Associated with In-Hospital Mortality after Continuous Renal Replacement Therapy for Critically Ill Patients: A Systematic Review and Meta-Analysis

Association Between the Neutrophil Percentage-to-Albumin Ratio and Outcomes in Cardiac Intensive Care Unit Patients

Incidence and outcomes of acute kidney injury stratified by cardiogenic shock severity

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