7 results on '"Bagshaw, Sean"'
Search Results
2. Incidence and outcomes of acute kidney injury following orthotopic lung transplantation: a population-based cohort study.
- Author
-
Fidalgo, Pedro, Ahmed, Mohammed, Meyer, Steven R., Lien, Dale, Weinkauf, Justin, Cardoso, Filipe S., Jackson, Kathy, and Bagshaw, Sean M.
- Subjects
KIDNEY injuries ,DISEASE incidence ,HEALTH outcome assessment ,KIDNEY transplantation ,COHORT analysis ,CYCLOSPORINE - Abstract
Background Acute kidney injury (AKI) is a serious complication following lung transplantation (LTx). We aimed to describe the incidence and outcomes associated with AKI following LTx. Methods A retrospective population-based cohort study of all adult recipients of LTx at the University of Alberta between 1990 and 2011. The primary outcome was AKI, defined and classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, in the first 7 post-operative days. Secondary outcomes included risk factors, utilization of renal replacement therapy (RRT), occurrence of post-operative complications, mortality and kidney recovery. Results Of 445 LTx recipients included, AKI occurred in 306 (68.8%), with severity classified as Stage I in 38.9% (n = 173), Stage II in 17.5% (n = 78) and Stage III in 12.4% (n = 55). RRT was received by 36 (8.1%). Factors associated with AKI included longer duration of cardiopulmonary bypass [per minute, odds ratio (OR) 1.003; 95% confidence interval (CI), 1.001–1.006; P = 0.02], and mechanical ventilation [per hour (log-transformed), OR 5.30; 95% CI, 3.04–9.24; P < 0.001], and use of cyclosporine (OR 2.03; 95% CI, 1.13–3.64; P = 0.02). In-hospital and 1-year mortality were significantly higher in those with AKI compared with no AKI (7.2 versus 0%; adjusted P = 0.001; 14.4 versus 5.0%; adjusted P = 0.02, respectively). At 3 months, those with AKI had greater sustained loss of kidney function compared with no AKI [estimated glomerular filtration rate, mean (SD): 68.9 (25.7) versus 75.3 (22.1) mL/min/1.73 m2, P = 0.01]. Conclusions By the KDIGO definition, AKI occurred in two-thirds of patients following LTx. AKI portended greater risk of death and loss of kidney function. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
3. Association between renal replacement therapy in critically ill patients with severe acute kidney injury and mortality.
- Author
-
Bagshaw, Sean M., Uchino, Shigehiko, Kellum, John A., Morimatsu, Hiroshi, Morgera, Stanislao, Schetz, Miet, Tan, Ian, Bouman, Catherine, Macedo, Etienne, Gibney, Noel, Tolwani, Ashita, Oudemans-van Straaten, Heleen M., Ronco, Claudio, and Bellomo, Rinaldo
- Subjects
KIDNEY injuries ,BODY weight ,CRITICAL care medicine ,CRITICALLY ill ,INTENSIVE care units ,KIDNEY diseases ,LONGITUDINAL method ,MEDICAL care ,EVALUATION of medical care ,PATIENTS ,THERAPEUTICS ,DATA analysis ,ACQUISITION of data - Abstract
Purpose: To evaluate the characteristics and outcomes of critically ill patients with severe acute kidney injury (AKI) treated and not treated with renal replacement therapy (RRT). Methods: Secondary analysis of a multi-centre cohort study. Primary exposure was RRT. Primary outcome was propensity and multi-variable adjusted-hospital mortality. Results: We studied 1250 patients (71.3%) who received and 502 (28.7%) who did not receive RRT. Reasons for not starting RRT (not mutually exclusive) were limitations of support (33.6%, n=169), adequate urine output (46.2%; n=232), plan to observe (56.4%; n=283), and advanced age (12.6%; n=63). Mortality was higher in those not receiving RRT due to limitations and advanced age but lower for adequate urine output and plan to observe. Propensity and multi-variable adjusted analysis showed no statistical difference in hospital mortality (adj-OR 1.47; 95% CI, 0.93-2.24) in patients receiving RRT. Results were similar in a sensitivity analysis restricted to patients fulfilling risk, injury, failure, loss, end-stage kidney disease-FAILURE criteria (37.0%; n= 446) (adj-OR 1.36; 95% CI, 0.70-2.66). Conclusion: In this cohort, reasons for not starting RRT included limitations of support and perception of impending renal recovery. Despite similar risk of mortality after adjusting for selection bias and confounders, RRT-treated patients were fundamentally different from non-treated patients across a spectrum of variables that precludes valid comparison in observational data. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
4. Clinical factors associated with initiation of renal replacement therapy in critically ill patients with acute kidney injury—A prospective multicenter observational study.
- Author
-
Bagshaw, Sean M., Wald, Ron, Barton, Jim, Burns, Karen E.A., Friedrich, Jan O., House, Andrew A., James, Matthew T., Levin, Adeera, Moist, Louise, Pannu, Neesh, Stollery, Daniel E., and Walsh, Michael W.
- Subjects
KIDNEY injuries ,THERAPEUTICS ,BODY weight ,CRITICAL care medicine ,CRITICALLY ill ,EPIDEMIOLOGY ,INTENSIVE care units ,KIDNEY diseases ,LONGITUDINAL method ,EVALUATION of medical care ,PATIENTS ,POSTOPERATIVE care ,U-statistics ,DATA analysis ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
Abstract: Purpose: Our objective was to describe the current practice for initiation of RRT in this population. There is uncertainty regarding the optimal time to initiate renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI). Methods: Prospective study of patients receiving RRT in 6 intensive care units (ICUs) at 3 hospitals from July 2007 to August 2008. We characterized factors associated with start of RRT and evaluated their relationship with mortality. Results: We included 234 patients. RRT was initiated 1 day (0-4) after ICU admission (median [interquartile range]). Median creatinine was 331 μmol/L (225-446 μmol/L), urea 22.9 mmol/L (13.9-32.9 mmol/L), and RIFLE-Failure in 76.9%. Of traditional indications, Pao
2 /Fio2 < 200 (54.5%) and oliguria (32.9%) were most common. ICU and hospital mortality were 45.3% and 51.9%, respectively. In adjusted analysis, mortality at RRT initiation was associated with creatinine <332 μmol/L (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.5-5.4), change in urea from admission >8.9 mmol/L (OR 1.8; 95% CI, 1.0-3.4), urine output <82 mL/24 hours (OR 3.0; 95% CI, 1.4-6.5), fluid balance >3.0 L/24 hours (OR 2.3; 95% CI, 1.2-4.5), percentage of fluid overload >5% (OR 2.3; 95% CI, 1.2-4.7), 3 or more failing organs (OR 4.5; 95% CI, 1.2-4.2), Sequential Organ Failure Assessment score >14 (OR 2.3; 95% CI, 1.3-4.3), and start 4 days or more after admission (OR 4.3; 95% CI, 1.9-9.5). Mortality was higher as factors accumulated. Conclusion: In ICU patients requiring RRT, there was marked variation in factors that influence start of RRT. RRT initiation with fewer clinical triggers was associated with lower mortality. Timing of RRT may modify survival but requires appraisal in a randomized trial. [Copyright &y& Elsevier]- Published
- 2012
- Full Text
- View/download PDF
5. An Evaluation of Intraoperative Renal Support during Liver Transplantation: A Matched Cohort Study.
- Author
-
Parmar, Ambica, Bigam, David, Meeberg, Glenda, Cave, Dominic, Townsend, Derek R., Gibney, R.T. Noel, and Bagshaw, Sean M.
- Subjects
INTRAOPERATIVE monitoring ,LIVER transplantation ,KIDNEY injuries ,VASOCONSTRICTORS ,MORTALITY - Abstract
Background: Intraoperative continuous renal replacement therapy (CRRT) has been utilized during liver transplantation (LT). Our objective was to assess intraoperative CRRT for metabolic control, postoperative complications and outcomes. Methods: Retrospective matched cohort study. Cases were LT patients receiving intraoperative CRRT. Controls were matched for demographics and Model for End-Stage Liver Disease (MELD) score. Data were extracted on physiology, course and outcomes. Results: 72 patients were included. Despite effort to match by MELD, cases had higher scores (35.4 vs. 29.9, p = 0.01) compared to controls. Preoperatively, cases received more vasopressors (p = 0.006), and more RRT (94.4 vs. 25.7%, p < 0.0001). There was no difference in complications (p = 0.35) or ICU re-admission rate (p = 0.29). Cases were more likely to require postoperative RRT (p < 0.0001). There was no difference in hospital mortality (p = 0.61). Conclusions: LT patients selected for intraoperative CRRT more commonly have hemodynamic instability and preoperative acute kidney injury requiring RRT. Despite higher illness severity for cases, there were no differences in complications or mortality. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
6. Transient azotaemia is associated with a high risk of death in hospitalized patients.
- Author
-
Uchino, Shigehiko, Bellomo, Rinaldo, Bagshaw, Sean M., and Goldsmith, Donna
- Subjects
KIDNEY injuries ,EPIDEMIOLOGICAL research ,MORTALITY ,CAUSES of death ,HOSPITAL patients ,NECROSIS ,DIAGNOSIS - Abstract
Background.There are no suitably powered epidemiological studies of ‘transient azotaemia’ (TA). The objective of this study was to describe the epidemiology of TA and its independent association with hospital mortality. We hypothesized that TA would be associated with an independent increase in the risk of death. [ABSTRACT FROM PUBLISHER]
- Published
- 2010
- Full Text
- View/download PDF
7. Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: A meta-analysis.
- Author
-
Bagshaw, Sean M., Berthiaume, Luc R., Delaney, Anthony, and Bellomo, Rinaldo
- Subjects
- *
THERAPEUTICS , *CRITICALLY ill , *PATIENTS , *KIDNEY injuries , *ACUTE kidney failure , *MORTALITY , *THERAPEUTIC complications - Abstract
The article provides a systematic review of randomized trials comparing intermittent renal replacement therapy (IRRT) and continuous RRT (CRRT) modality for critically-ill patients with acute kidney injury (AKI). The review's objectives were to evaluate whether modality influences mortality, renal recovery, treatment-related complications and physiologic outcomes. The study found no difference in mortality or renal recovery to RRT independence.
- Published
- 2008
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.