Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.026
Brazilian Journal of Anesthesiology
Original Investigation

Association between acute kidney injury and mortality after successful cardiopulmonary resuscitation: a retrospective observational study

Associação entre lesão renal aguda e mortalidade após ressuscitação cardiopulmonar bem-sucedida: um estudo observacional retrospectivo

Ender Para; Mustafa Azizoğlu; Aslinur Sagün; Gülhan Orekici Temel; Handan Birbiçer

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Abstract

Background and objectives: Acute Kidney Injury (AKI) affect mortality and morbidity in critically ill patients. There have been few studies examining the prevalence of AKI and mortality after successful cardiopulmonary resuscitation. In the present study, we investigated the association between AKI and mortality in post-cardiac arrest patients admitted to the Intensive Care Unit (ICU).

Methods: Our retrospective analysis included 109 patients, admitted to the ICU following successful cardiopulmonary resuscitation between 2014 and 2016. We compared two scoring systems to estimate mortality.

Results and discussion: AKI were diagnosed in 46.7% (n = 51) of the patients based on the RIFLE criteria and 66.1% (n = 72) using the KDIGO. Mortality rate was significantly higher among patients with AKI diagnosed according to the RIFLE criteria (p = 0.012) and those with AKI diagnosed using KDIGO criteria (p = 0.003). Receiver Operating Characteristic (ROC) analysis showed that both scoring systems were able to successfully detect mortality (Area under the ROC curve = 0.693 for RIFLE and 0.731 for KDIGO).

Conclusion: AKI increases mortality and morbidity rates after cardiac arrest. Although more renal injury and mortality were detected with KDIGO, the sensitivity and specificity of both scoring systems were similar in predicting mortality in patients with Return of Spontaneous Circulation (ROSC).

Keywords

Acute kidney injury, Post-cardiac arrest, RIFLE, KDIGO

Resumo

Justificativa e objetivos: A Lesão Renal Aguda (LRA) afeta a mortalidade e morbidade em pacientes criticamente enfermos. Existem poucos estudos examinando a prevalência de IRA e mortalidade após a ressuscitação cardiopulmonar bem-sucedida. No presente estudo, investigamos a associação entre LRA e mortalidade em pacientes pós-parada cardíaca internados em Unidade de Terapia Intensiva (UTI).

Métodos: Nossa análise retrospectiva incluiu 109 pacientes internados na UTI após ressuscitação cardiopulmonar bem-sucedida entre 2014 e 2016. Comparamos dois sistemas de pontuação para estimar a mortalidade. 

Resultados e discussão: LRA foi diagnosticada em 46,7% (n = 51) dos pacientes pelos critérios do RIFLE e em 66,1% (n = 72) pelo KDIGO. A taxa de mortalidade foi significativamente maior entre os pacientes com LRA diagnosticada pelos critérios RIFLE (p = 0,012) e aqueles com LRA diagnosticada pelos critérios KDIGO (p = 0,003). A análise de Característica de Operação do Receptor (COR) mostrou que ambos os sistemas de pontuação foram capazes de detectar com sucesso a mortalidade (área sob a curva COR = 0,693 para RIFLE e 0,731 para KDIGO).

Conclusão: LRA aumenta as taxas de mortalidade e morbidade após a parada cardíaca. Embora mais lesão renal e mortalidade tenham sido detectadas com KDIGO, a sensibilidade e especificidade de ambos os sistemas de pontuação foram semelhantes na previsão de mortalidade em pacientes com Retorno da Circulação Espontânea (RCE).

Palavras-chave

Lesão renal aguda, Pós-parada cardíaca, RIFLE, KDIGO

References

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Submitted date:
07/03/2019

Accepted date:
01/15/2021

6036ce33a953956983739253 rba Articles

Braz J Anesthesiol

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