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A clinical score to predict mortality in septic acute kidney injury patients requiring continuous renal replacement therapy: the HELENICC score

机译:预测需要持续肾脏替代治疗的脓毒症急性肾损伤患者死亡率的临床评分:HELENICC评分

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Background This study aimed to identify predictors of early (7-day) mortality in patients with septic acute kidney injury (AKI) who required continuous renal replacement therapy (CRRT). Methods Prospective cohort of 186 septic AKI patients undergoing CRRT at a tertiary hospital, from October 2005 to November 2010. Results After multivariate adjustment, five variables were associated to early mortality: norepinephrine utilization, liver failure, medical condition, lactate level, and pre-dialysis creatinine level. These variables were combined in a score, which demonstrated good discrimination, with a C-statistic of 0.82 (95% CI?=?0.76–0.88), and good calibration ( χ 2?=?4.3; p =?0.83). SAPS 3, APACHE II and SOFA scores demonstrated poor performance in this population. Conclusions The HEpatic failure, LactatE, NorepInephrine, medical Condition, and Creatinine (HELENICC) score outperformed tested generic models. Future studies should further validate this score in different cohorts.
机译:背景技术本研究旨在确定需要持续肾脏替代治疗(CRRT)的脓毒性急性肾损伤(AKI)患者早期(7天)死亡率的预测指标。方法从2005年10月至2010年11月,在三级医院对186名接受CRRT的脓毒症AKI患者进行前瞻性队列研究。结果经多变量调整后,与早期死亡率相关的有五个变量:去甲肾上腺素利用率,肝功能衰竭,医疗状况,乳酸水平和预透析肌酐水平。这些变量组合在一起,表现出良好的辨别力,C统计量为0.82(95%CI?=?0.76-0.88),并且校准良好(χ 2 ?=?4.3; p = 0.83)。 SAPS 3,APACHE II和SOFA分数表明该人群的表现不佳。结论肝衰竭,LactatE,NorepInephrine,医学状况和肌酐(HELENICC)评分优于测试的通用模型。未来的研究应在不同的队列中进一步验证该分数。

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