dc.contributorPUCRS
dc.contributorUniversidade Federal de São Paulo (UNIFESP)
dc.creatord'Avila, D. O.
dc.creatorNeto, M. C.
dc.creatorSantos, OFP dos
dc.creatorSchor, N.
dc.creatorFigueiredo, CEP de
dc.date.accessioned2016-01-24T12:34:13Z
dc.date.accessioned2023-09-04T18:23:28Z
dc.date.available2016-01-24T12:34:13Z
dc.date.available2023-09-04T18:23:28Z
dc.date.created2016-01-24T12:34:13Z
dc.date.issued2004-01-01
dc.identifierRenal Failure. New York: Marcel Dekker Inc, v. 26, n. 1, p. 59-68, 2004.
dc.identifier0886-022X
dc.identifierhttp://repositorio.unifesp.br/handle/11600/27557
dc.identifier10.1081/JDI-120028552
dc.identifierWOS:000220583900011
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8614034
dc.description.abstractBackground: Generic prognostic scores used in acute renal failure (ARE) give imprecise results; disease-specific indices applied to distinct populations or intensive care practices becomes inaccurate. the current study evaluates the adequacy of prognostic scores, in patients with severe ARE needing dialysis. Methods: Known generic (APACHE 11) and disease-specific (ATN-ISS) indices were applied to a cohort (n=280) with ARE needing dialysis, under intensive care. Possible risk factors as causal factors, organ dysfunctions and clinical variables were examined, and a local index assembled by multivariate logistic regression analysis. Area under the receiver operating characteristics (ROC) curves evaluated the indices discriminating capacity. Goodness-of-fit testing and linear regression analysis appraised calibration. Validation was accomplished by the bootstrapping technique. the end-point was hospital mortality. Results: Overall mortality Was 85%. Female gender <44 years (OR: 0.29; 95% CI: 0.10-0.84), liver/obstructive biliary disease (OR: 6.03; 95%CI: 1.65-22.08), being conscious (OR: 0.49; 95%CI: 0.21 - 1.14), use of vasoactive drug (OR: 3.13 95%CI: 1.25-7.83), respiratory dysfunction (OR: 5.20 95%CI: 1.25-7.83) or sepsis (OR: 2.62; 95%CI: 1.14-6.02) were associated with outcome. Areas under the ROC curve of 0.815, 0.652 and 0.814; Goodness-of-fit test P=0.593, P<0.001 and P=0.002; and linear regression R-2=0.973, R-2=0.526 and R-2=0.919 for the local index, APACHE 11 and ATN-ISS, respectively, indicate better performance by the local index. the local index median area under the ROC curve, by bootstrapping, was 0.820 (95% CI: 0.741-0.907). Conclusions: APACHE 11 score was inaccurate, and ATN-ISS poorly calibrated. When mortality or intensive care practices significantly deviate, local scores may better evaluate prognosis in severe ARF.
dc.languageeng
dc.publisherMarcel Dekker Inc
dc.relationRenal Failure
dc.rightsAcesso restrito
dc.subjecthospital mortality
dc.subjectorgan dysfunction
dc.subjectrenal replacement therapy
dc.subjectrisk stratification
dc.subjectscoring systems
dc.titleAcute renal failure needing dialysis in the intensive care unit and prognostic scores
dc.typeArtigo


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