1. Outcome prediction of acute renal failure in medical intensive care
- Author
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Schaefer Jh, Jochimsen F, K. Wegscheider, F. Keller, and Armin Distler
- Subjects
medicine.medical_specialty ,Critical Care ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,law.invention ,Predictive Value of Tests ,Renal Dialysis ,law ,Intensive care ,Anesthesiology ,Severity of illness ,medicine ,Humans ,Prospective Studies ,Intensive care medicine ,Diagnosis-Related Groups ,Dialysis ,Mechanical ventilation ,APACHE II ,business.industry ,Acute Kidney Injury ,Prognosis ,Respiration, Artificial ,Intensive care unit ,Survival Rate ,Intensive Care Units ,Outcome and Process Assessment, Health Care ,Predictive value of tests ,Hypotension ,business - Abstract
Data acquired prospectively from 134 patients with acute renal failure requiring dialysis in a medical intensive care unit (ICU) were analysed in order to derive indicators predicting ICU-survival. Mortality in the ICU was 56.7%. Linear discriminant analysis correctly predicted outcome in 79.9% at the start of dialysis, and 84.7% at 48 h after the first dialysis. The most important predictive variables were mechanical ventilation and low blood pressure. On the other hand, the total correct classification rates achieved by a standardised system for scoring ICU-patients (APACHE II) did not exceed 58.2%. It is concluded that outcome prediction by APACHE II and even by the discriminant functions is too inaccurate to become the basis for clinical decisions either concerning the initiation or the continuation of dialysis treatment in ARF.
- Published
- 1991
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