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Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk?
BACKGROUND: We examined the prevalence of acute kidney injury (AKI) risk factors in the emergency medical unit, generated a modified risk assessment tool and tested its ability to predict AKI. METHODS: A total of 1196 patients admitted to medical admission units were assessed for patient-associated...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655789/ https://www.ncbi.nlm.nih.gov/pubmed/26613022 http://dx.doi.org/10.1093/ckj/sfv080 |
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author | Roberts, Gareth Phillips, Dafydd McCarthy, Rowan Bolusani, Hemanth Mizen, Paul Hassan, Mohamed Hooper, Rachel Saddler, Kimberly Hu, Mo Lodhi, Sonal Toynton, Ella Geen, John Lodhi, Vikas Grose, Catherine Phillips, Aled |
author_facet | Roberts, Gareth Phillips, Dafydd McCarthy, Rowan Bolusani, Hemanth Mizen, Paul Hassan, Mohamed Hooper, Rachel Saddler, Kimberly Hu, Mo Lodhi, Sonal Toynton, Ella Geen, John Lodhi, Vikas Grose, Catherine Phillips, Aled |
author_sort | Roberts, Gareth |
collection | PubMed |
description | BACKGROUND: We examined the prevalence of acute kidney injury (AKI) risk factors in the emergency medical unit, generated a modified risk assessment tool and tested its ability to predict AKI. METHODS: A total of 1196 patients admitted to medical admission units were assessed for patient-associated AKI risk factors. Subsequently, 898 patients were assessed for a limited number of fixed risk factors with the addition of hypotension and sepsis. This was correlated to AKI episodes. RESULTS: In the first cohort, the prevalence of AKI risk factors was 2.1 ± 2.0 per patient, with a positive relationship between age and the number of risk factors and a higher number of risk factors in patients ≥65 years. In the second cohort, 12.3% presented with or developed AKI. Patients with AKI were older and had a higher number of AKI risk factors. In the AKI cohort, 72% of the patients had two or more AKI risk factors compared with 43% of the cohort with no AKI. When age ≥65 years was added as an independent risk factor, 84% of those with AKI had two or more AKI risk factors compared with 55% of those with no AKI. Receiver operating characteristic analysis suggests that the use of common patient-associated known AKI risk factors performs no better than age alone as a predictor of AKI. CONCLUSIONS: Detailed assessment of well-established patient-associated AKI risk factors may not facilitate clinicians to apportion risk. This suggests that additional work is required to develop a more sensitive validated AKI-predictive tool that would be useful in this clinical setting. |
format | Online Article Text |
id | pubmed-4655789 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-46557892015-11-26 Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? Roberts, Gareth Phillips, Dafydd McCarthy, Rowan Bolusani, Hemanth Mizen, Paul Hassan, Mohamed Hooper, Rachel Saddler, Kimberly Hu, Mo Lodhi, Sonal Toynton, Ella Geen, John Lodhi, Vikas Grose, Catherine Phillips, Aled Clin Kidney J Contents BACKGROUND: We examined the prevalence of acute kidney injury (AKI) risk factors in the emergency medical unit, generated a modified risk assessment tool and tested its ability to predict AKI. METHODS: A total of 1196 patients admitted to medical admission units were assessed for patient-associated AKI risk factors. Subsequently, 898 patients were assessed for a limited number of fixed risk factors with the addition of hypotension and sepsis. This was correlated to AKI episodes. RESULTS: In the first cohort, the prevalence of AKI risk factors was 2.1 ± 2.0 per patient, with a positive relationship between age and the number of risk factors and a higher number of risk factors in patients ≥65 years. In the second cohort, 12.3% presented with or developed AKI. Patients with AKI were older and had a higher number of AKI risk factors. In the AKI cohort, 72% of the patients had two or more AKI risk factors compared with 43% of the cohort with no AKI. When age ≥65 years was added as an independent risk factor, 84% of those with AKI had two or more AKI risk factors compared with 55% of those with no AKI. Receiver operating characteristic analysis suggests that the use of common patient-associated known AKI risk factors performs no better than age alone as a predictor of AKI. CONCLUSIONS: Detailed assessment of well-established patient-associated AKI risk factors may not facilitate clinicians to apportion risk. This suggests that additional work is required to develop a more sensitive validated AKI-predictive tool that would be useful in this clinical setting. Oxford University Press 2015-12 2015-08-30 /pmc/articles/PMC4655789/ /pubmed/26613022 http://dx.doi.org/10.1093/ckj/sfv080 Text en © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Contents Roberts, Gareth Phillips, Dafydd McCarthy, Rowan Bolusani, Hemanth Mizen, Paul Hassan, Mohamed Hooper, Rachel Saddler, Kimberly Hu, Mo Lodhi, Sonal Toynton, Ella Geen, John Lodhi, Vikas Grose, Catherine Phillips, Aled Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? |
title | Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? |
title_full | Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? |
title_fullStr | Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? |
title_full_unstemmed | Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? |
title_short | Acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? |
title_sort | acute kidney injury risk assessment at the hospital front door: what is the best measure of risk? |
topic | Contents |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655789/ https://www.ncbi.nlm.nih.gov/pubmed/26613022 http://dx.doi.org/10.1093/ckj/sfv080 |
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