Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5405
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dc.contributor.authorWhite, Kyle Cen
dc.contributor.authorSerpa-Neto, Aryen
dc.contributor.authorHurford, Roden
dc.contributor.authorClement, Pierreen
dc.contributor.authorLaupland, Kevin Ben
dc.contributor.authorSee, Emilyen
dc.contributor.authorMcCullough, Jamesen
dc.contributor.authorWhite, Haydenen
dc.contributor.authorShekar, Kiranen
dc.contributor.authorTabah, Alexisen
dc.contributor.authorRamanan, Maheshen
dc.contributor.authorGarrett, Peteren
dc.contributor.authorAttokaran, Antony Gen
dc.contributor.authorLuke, Stephenen
dc.contributor.authorSenthuran, Sivaen
dc.contributor.authorMcIlroy, Philippaen
dc.contributor.authorBellomo, Rinaldoen
dc.date.accessioned2023-10-24T06:04:57Z-
dc.date.available2023-10-24T06:04:57Z-
dc.date.issued2023-
dc.identifier.citationWhite KC, Serpa-Neto A, Hurford R, Clement P, Laupland KB, See E, McCullough J, White H, Shekar K, Tabah A, Ramanan M, Garrett P, Attokaran AG, Luke S, Senthuran S, McIlroy P, Bellomo R; Queensland Critical Care Research Network (QCCRN). Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational study. Intensive Care Med. 2023 Sep;49(9):1079-1089. doi: 10.1007/s00134-023-07138-0. Epub 2023 Jul 11. PMID: 37432520; PMCID: PMC10499944.en
dc.identifier.urihttps://dora.health.qld.gov.au/qldresearchjspui/handle/1/5405-
dc.descriptionCairns & Hinterland Hospital and Health Service (CHHHS) affiliated author: Philippa McIlroyen
dc.description.abstractThe Acute Disease Quality Initiative (ADQI) Workgroup recently released a consensus definition of sepsis-associated acute kidney injury (SA-AKI), combining Sepsis-3 and Kidney Disease Improving Global Outcomes (KDIGO) AKI criteria. This study aims to describe the epidemiology of SA-AKI. This is a retrospective cohort study carried out in 12 intensive care units (ICUs) from 2015 to 2021. We studied the incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes of SA-AKI based on the ADQI definition. Out of 84,528 admissions, 13,451 met the SA-AKI criteria with its incidence peaking at 18% in 2021. SA-AKI patients were typically admitted from home via the emergency department (ED) with a median time to SA-AKI diagnosis of 1 day (interquartile range (IQR) 1-1) from ICU admission. At diagnosis, most SA-AKI patients (54%) had a stage 1 AKI, mostly due to the low urinary output (UO) criterion only (65%). Compared to diagnosis by creatinine alone, or by both UO and creatinine criteria, patients diagnosed by UO alone had lower renal replacement therapy (RRT) requirements (2.8% vs 18% vs 50%; p < 0.001), which was consistent across all stages of AKI. SA-AKI hospital mortality was 18% and SA-AKI was independently associated with increased mortality. In SA-AKI, diagnosis by low UO only, compared to creatinine alone or to both UO and creatinine criteria, carried an odds ratio of 0.34 (95% confidence interval (CI) 0.32-0.36) for mortality. SA-AKI occurs in 1 in 6 ICU patients, is diagnosed on day 1 and carries significant morbidity and mortality risk with patients mostly admitted from home via the ED. However, most SA-AKI is stage 1 and mostly due to low UO, which carries much lower risk than diagnosis by other criteria.en
dc.language.isoenen
dc.relationQueensland Critical Care Research Networken
dc.relation.ispartofIntensive care medicineen
dc.subjectCritical careen
dc.subjectAcute kidney injuryen
dc.subjectSepsisen
dc.subjectSepsis-associated acute kidney injuryen
dc.titleSepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational studyen
dc.typeArticleen
dc.identifier.doi10.1007/s00134-023-07138-0-
dc.identifier.pmid37432520-
item.fulltextWith Fulltext-
item.grantfulltextopen-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.languageiso639-1en-
item.openairetypeArticle-
Appears in Sites:Cairns & Hinterland HHS Publications
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