A modified sequential organ failure assessment score to predict hospital mortality of postoperative acute renal failure patients requiring renal replacement therapy
Journal
Blood Purification
Journal Volume
26
Journal Issue
6
Pages
547-554
Date Issued
2008
Author(s)
Ko W.-J.
Hu F.-C.
Shiao C.-C.
Chen Y.-W.
Tsai P.-R.
Tsai C.-W.
Wu H.-Y.
Kuo C.-C.
Wu C.-F.
Abstract
Background: A predictive model for hospital mortality in postoperative acute renal failure (ARF) patients requiring renal replacement therapy (RRT) may aid clinicians' therapeutic decision-making and research design. Methods: A prospective observational study of 398 postoperative ARF patients requiring RRT was conducted in four hospitals. The derivation cohort consisted of 334 patients recruited between January 2002 and December 2005. The validation cohort consisted of 64 patients recruited between January 2006 and December 2006. Results: The hospital mortality rates for the derivation and validation cohorts were 65.6 and 62.5%, respectively. A modified Sequential Organ Failure Assessment (SOFA) score was constructed at the commencement of RRT by a formula of serum lactate level (mM) + 2 × (generic SOFA score) + 3 × (age per decade) + 8 (if mechanical circulatory support required) + 10 (if total parenteral nutrition required) + 11 (if status postcardiopulmonary resuscitation) + 13 (if positive sepsis sign). The area under the receiver operating characteristic curve of the model for the derivation and validation cohorts was 0.804 and 0.839, respectively. Conclusion: This validated score at dialysis commencement might assist clinicians in estimating hospital mortality, planning future clinical trials, and providing quantitative guidance for decision making in postoperative ARF patients requiring RRT. Copyright ? 2008 S. Karger AG.
SDGs
Other Subjects
acute kidney failure; adult; aged; area under the curve; article; clinical trial; cohort analysis; controlled study; female; hepatorenal syndrome; hospital; human; kidney disease; lactate blood level; male; medical decision making; mortality; observational study; parenteral nutrition; patient assessment; postoperative care; priority journal; prospective study; quantitative analysis; renal replacement therapy; resuscitation; risk factor; scoring system; sepsis; sequential analysis; shock; validation study; Adult; Aged; Aged, 80 and over; Algorithms; Female; Hospital Mortality; Humans; Kidney Failure, Acute; Kidney Transplantation; Male; Middle Aged; Multiple Organ Failure; Postoperative Complications; Prognosis; Prospective Studies; ROC Curve; Severity of Illness Index; Young Adult
Type
journal article