Incidence, Risk factors, and Impact of Acute Kidney Injury in Patients Admitted to Intensive Care Unit in Ratchaburi Hospital
Keywords:
acute kidney injury, risk factors, impactAbstract
ABSTRACT
Objective: The aim was to study the incidence, risk factors and impact of acute kidney injury in the patients admitted to Intensive care unit of Ratchaburi Hospital.
Methods: A retrospective descriptive study was conducted using data from the patients admitted to intensive care unit (ICU) of internal medicine in Ratchaburi Hospital between January 1, 2018 to June 30, 2018. We used the KDIGO 2012 criteria for definition of acute kidney injury (AKI). The data were analyzed by SPSS statistics 17.0 program and used logistical regression multivariate analysis to explore risk factors of acute kidney injury.
Results: A total of 115 patients were admitted to the ICU. The incidence of AKI was 69.6%. In AKI patients were found significantly higher of mechanical ventilation (100% vs 42.9,p=.0001), septic shock (46.2% vs 2.9 ,p=.0001), APACHE II score (29.26 vs 8.60 ,p=.0001), and creatinine level at ICU admission (4.23 mg/dL vs 0.97 mg/dL , p=.0001) than non-AKI patients. APACHE II score was independent a risk factor for acute kidney injury with OR (95%CI) 1.62 (1.286-2.041).In addition, ICU stay (16.28 ±20.92 days VS 5.49±5.19 days ;p=.003) and hospital stay (24.29±23.16 days VS 12.77±14.38 days ; p =.008) in AKI patients significantly longer than non-AKI patients.The mortality rate in AKI patients (66.2 %) was significantly higher than non-AKI patients(8.6%, p<.0001). Among AKI, 10%, 13.7% and 76.2% of the patients were classified as KDIGO stage 1,2 and 3 respectively. And mortality rate in KDIGO stage 3 patients were the most highest (79.2%). AKI patients were treated by renal replacement therapy about 36.2 %
Conclusion: The incidence of AKI in patients who admitted in ICU is very high. Septic shock, high APACHE II score, mechanical ventilation ,and high level of creatinine are risk factors of AKI. AKI significantly increases the duration of hospital stay and mortality ,so this is likely to add to the healthcare burden.
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