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논문분류	춘계학술대회 초록집
제목	Mortality Predictors in Critically Ill Patients after Continuous Renal Replacement Therapy-Requiring Acute Kidney Injury
저자	Kristianne Rachel Medina - Liabres, Hyung Jung Oh, Jung Nam An, Jung Pyo Lee, Dong Ki Kim, Dong-Ryeul Ryu, Sejoong Kim
출판정보	2020; 2020(1):
키워드	acute kidney injury \| hemodialysis \| CRRT \| mortality
초록	Studies are needed to identify patients who will most likely benefit from CRRT to guide therapeutic decisions, optimize limited resources, and provide realistic prognostic information. This study aims to determine mortality rates and mortality predictors among ICU patients with AKI requiring CRRT. This a retrospective, multi-center observational study of 414 ICU patients with AKI from June 2017-September 2018 who received CRRT. Primary outcomes are in-hospital and 90-day mortality. Logistic regression was used to explore the effects of variables on 90-day mortality. Kaplan-Meier survival analysis compared survival among groups classified based on degree of fluid overload (FO) and SOFA score. In-hospital mortality rate was 57.2%. Ninety day mortality rate was 58.5%. Lower creatinine and pH were significant predictors of in-hospital (creatinine p 0.000; pH p 0.007) and 90-day mortality (creatinine p 0.000; pH p 0.010). A 1-unit increase in SOFA score was associated with increased risk of in-hospital (OR 1.138, p 0.000) and 90-day mortality (OR 1.130, p 0.000). FO was also significantly associated with increased risk of in-hospital (OR 1.984, p 0.001) and 90-day mortality (OR 2.155, p 0.000). In patients without FO or FO≤10%, a high SOFA score was associated with increased OR for in hospital (1.849, p 0.021 and 2.920, p 0.001, respectively) and 90-day mortality (1.789, p 0.029 and 3.052, p 0.001, respectively). Mortality risk was not statistically different for FO≤10% patients with low SOFA score. Highest mortality rates were in FO>10% patients (in hospital: 82.1%, p .000; 90-day: 85.1%, p .000). Kaplan-Meier survival curve showed that patients with FO>10% had the lowest survival regardless of SOFA score. Creatinine, pH, SOFA score and FO are significant predictors of mortality. In patients without FO and FO≤10%, a lower SOFA score connotes higher survival. FO>10% patients have worse outcomes regardless of SOFA score hence strict fluid monitoring is essential.
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