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Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit

BACKGROUND: Between 30 and 70% of patients admitted to the intensive care unit (ICU) have acute kidney injury (AKI), and 10% of these patients will require renal replacement therapy (RRT). A significant number of studies have compared the mortality of patients who require RRT versus those who do not...

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Autores principales: Oliveros, Henry, Buitrago, Giancarlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437019/
https://www.ncbi.nlm.nih.gov/pubmed/32832092
http://dx.doi.org/10.1186/s40560-020-00481-0
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author Oliveros, Henry
Buitrago, Giancarlo
author_facet Oliveros, Henry
Buitrago, Giancarlo
author_sort Oliveros, Henry
collection PubMed
description BACKGROUND: Between 30 and 70% of patients admitted to the intensive care unit (ICU) have acute kidney injury (AKI), and 10% of these patients will require renal replacement therapy (RRT). A significant number of studies have compared the mortality of patients who require RRT versus those who do not require it, finding an increase in mortality rates in the short and medium term; however, few studies have evaluated the long-term survival in a mixture of patients admitted to the ICU. OBJECTIVE: To evaluate the impact of RRT on 5-year survival in patients with AKI admitted to the ICU METHODS: Using administrative databases of insurers of the Colombian health system, a cohort of patients admitted to the ICU between 1 January 2012 and 31 December 2013 was followed until 31 December 2018. ICD-10 diagnoses, procedure codes, and prescribed medications were used to establish the frequencies of the comorbidities included in the Charlson index. Patients were followed for at least 5 years to evaluate survival and establish the adjusted risks by propensity score matching. RESULTS: Of the 150,230 patients admitted to the ICU, 4366 (2.9%) required RRT in the ICU. Mortality rates for patients with RRT vs no RRT evaluated at ICU discharge, 1 year, and 5 years were 35%, 57.4%, and 67.9% vs 7.4%, 17.6%, and 30.1%, respectively. After propensity score matching, the hazard ratio was calculated for patients who received RRT and those who did not (HR, 2.46; 95% CI 2.37 to 2.56; p < 0.001), with a lower difference in years of survival for patients with RRT (mean effect in the treated) of − 1.86 (95% CI − 2.01 to to1.65; p < 0.001). CONCLUSIONS: The impact of acute renal failure with the consequent need for RRT in patients admitted to the ICU is reflected in a decrease of approximately one quarter in 5-year survival, regardless of the different comorbidities.
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spelling pubmed-74370192020-08-20 Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit Oliveros, Henry Buitrago, Giancarlo J Intensive Care Research BACKGROUND: Between 30 and 70% of patients admitted to the intensive care unit (ICU) have acute kidney injury (AKI), and 10% of these patients will require renal replacement therapy (RRT). A significant number of studies have compared the mortality of patients who require RRT versus those who do not require it, finding an increase in mortality rates in the short and medium term; however, few studies have evaluated the long-term survival in a mixture of patients admitted to the ICU. OBJECTIVE: To evaluate the impact of RRT on 5-year survival in patients with AKI admitted to the ICU METHODS: Using administrative databases of insurers of the Colombian health system, a cohort of patients admitted to the ICU between 1 January 2012 and 31 December 2013 was followed until 31 December 2018. ICD-10 diagnoses, procedure codes, and prescribed medications were used to establish the frequencies of the comorbidities included in the Charlson index. Patients were followed for at least 5 years to evaluate survival and establish the adjusted risks by propensity score matching. RESULTS: Of the 150,230 patients admitted to the ICU, 4366 (2.9%) required RRT in the ICU. Mortality rates for patients with RRT vs no RRT evaluated at ICU discharge, 1 year, and 5 years were 35%, 57.4%, and 67.9% vs 7.4%, 17.6%, and 30.1%, respectively. After propensity score matching, the hazard ratio was calculated for patients who received RRT and those who did not (HR, 2.46; 95% CI 2.37 to 2.56; p < 0.001), with a lower difference in years of survival for patients with RRT (mean effect in the treated) of − 1.86 (95% CI − 2.01 to to1.65; p < 0.001). CONCLUSIONS: The impact of acute renal failure with the consequent need for RRT in patients admitted to the ICU is reflected in a decrease of approximately one quarter in 5-year survival, regardless of the different comorbidities. BioMed Central 2020-08-18 /pmc/articles/PMC7437019/ /pubmed/32832092 http://dx.doi.org/10.1186/s40560-020-00481-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Oliveros, Henry
Buitrago, Giancarlo
Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit
title Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit
title_full Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit
title_fullStr Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit
title_full_unstemmed Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit
title_short Effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit
title_sort effect of renal support therapy on 5-year survival in patients discharged from the intensive care unit
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437019/
https://www.ncbi.nlm.nih.gov/pubmed/32832092
http://dx.doi.org/10.1186/s40560-020-00481-0
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