1. SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy
- Author
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Jiangli Sun, Yu Shi, Hong Hong Pei, Zheng-Hai Bai, Hai Wang, Xiao Kang, and Jun-Hua Lv
- Subjects
Adult ,Male ,China ,medicine.medical_specialty ,Time Factors ,Continuous Renal Replacement Therapy ,Organ Dysfunction Scores ,Critical Illness ,medicine.medical_treatment ,030232 urology & nephrology ,Apache II score ,030204 cardiovascular system & hematology ,lcsh:RC870-923 ,Critical Care and Intensive Care Medicine ,Risk Assessment ,APACHE-II score ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,parasitic diseases ,medicine ,Humans ,Renal replacement therapy ,SOFA score ,APACHE ,Aged ,Retrospective Studies ,urogenital system ,business.industry ,Critically ill ,Acute kidney injury ,General Medicine ,Acute Kidney Injury ,Middle Aged ,lcsh:Diseases of the genitourinary system. Urology ,Prognosis ,medicine.disease ,Intensive Care Units ,Logistic Models ,Nephrology ,Multivariate Analysis ,Clinical Study ,Female ,Multiple organ dysfunction syndrome ,business ,Research Article - Abstract
Background Acute kidney injury (AKI) is the most common cause of organ failure in multiple organ dysfunction syndrome (MODS) and is associated with increased mortality. This study aimed at determining the efficacy of sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation II (APACHE-II) scoring systems in assessing the prognosis of critically ill patients with AKI undergoing continuous renal replacement therapy (CRRT). At present, APACHE-II score and SOFA score were also used to evaluate and predict the prognosis of critically ill patients with AKI. Methods The predictive value of SOFA and APACHE-II scores for 28- and 90-d mortality in patients with AKI undergoing CRRT were determined by multivariate analysis, sensitivity analysis, and curve-fitting analysis. Results A total of 836 cases were included in this study. Multivariate Cox logistic regression analysis showed that SOFA scores were associated with 28- and 90-d mortality in patients with AKI undergoing CRRT. The adjusted HR of SOFA for 28-d mortality were 1.18 (1.14, 1.21), 1.24 (1.18, 1.31), and 1.19 (1.13, 1.24) in the three models, respectively, and the adjusted HR of SOFA for 90-d mortality was 1.12 (1.09, 1.16), 1.15 (1.10, 1.19), and 1.15 (1.10, 1.19), respectively. The subgroup analysis showed that the SOFA score was associated with 28-d and 90-d mortality in patients with AKI undergoing CRRT. APACHE-II score was not associated with 28- and 90-d mortality patients with AKI undergoing CRRT. Curve fitting analysis showed that SOFA scores increased had a higher prediction accuracy for 28- and 90-d than APACHE-II. Conclusions The SOFA score showed a higher accuracy of mortality prediction in critically ill patients with AKI undergoing CRRT than the APACHE-II score.
- Published
- 2020
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