Severity scores underestimate the seriousness of acute renal failure after emergency surgery
The predictive value of APACHE II and SAPS severity scores were evaluated in a group of patients with acute renal failure admitted in ICU after emergency surgery. The criteria of poor prognosis identified in the 24 hours following admission were also evaluated. Open prospective study. During 22 mont...
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| Veröffentlicht in: | Annales françaises d'anesthésie et de réanimation 1995, Vol.14 (6), p.478-483 |
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| container_title | Annales françaises d'anesthésie et de réanimation |
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| creator | Frikha, M Montravers, P Vogel, J Enriquez, I Nimier, M Dureuil, B Desmonts, J M |
| description | The predictive value of APACHE II and SAPS severity scores were evaluated in a group of patients with acute renal failure admitted in ICU after emergency surgery. The criteria of poor prognosis identified in the 24 hours following admission were also evaluated.
Open prospective study.
During 22 months, we included every patient admitted in ICU after emergency surgery with a serum creatinine concentration > or = 130 mumol.L-1. Clinical and biological parameters were collected in the first 24 hours following admission and the severity scores were calculated. Prediction of hospital outcome, based on APACHE II score, was calculated. The standard mortality ratio (observed mortality/predicted mortality) was calculated. Accuracy of SAPS and APACHE II score was compared using ROC curves and comparison of the areas under the curves.
Death in ICU occurred in 44% of the patients while hospital mortality was 51%. The standard mortality ratio for APACHE II score was 1.35. The areas under the curves for SAPS and APACHE II scores were not statistically different. The criteria of poor prognosis, identified in the first 24 hours following admission, were cardiovascular failure, oliguria and sepsis.
Conventional severity scores are inaccurate for prediction of mortality in patients with acute renal failure following emergency surgery. |
| format | Article |
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Open prospective study.
During 22 months, we included every patient admitted in ICU after emergency surgery with a serum creatinine concentration > or = 130 mumol.L-1. Clinical and biological parameters were collected in the first 24 hours following admission and the severity scores were calculated. Prediction of hospital outcome, based on APACHE II score, was calculated. The standard mortality ratio (observed mortality/predicted mortality) was calculated. Accuracy of SAPS and APACHE II score was compared using ROC curves and comparison of the areas under the curves.
Death in ICU occurred in 44% of the patients while hospital mortality was 51%. The standard mortality ratio for APACHE II score was 1.35. The areas under the curves for SAPS and APACHE II scores were not statistically different. The criteria of poor prognosis, identified in the first 24 hours following admission, were cardiovascular failure, oliguria and sepsis.
Conventional severity scores are inaccurate for prediction of mortality in patients with acute renal failure following emergency surgery.</description><identifier>ISSN: 0750-7658</identifier><identifier>PMID: 8745971</identifier><language>fre</language><publisher>France</publisher><subject>Acute Kidney Injury - diagnosis ; Acute Kidney Injury - etiology ; Acute Kidney Injury - mortality ; Acute Kidney Injury - physiopathology ; Critical Care ; Emergencies ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications - mortality ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Assessment ; Severity of Illness Index</subject><ispartof>Annales françaises d'anesthésie et de réanimation, 1995, Vol.14 (6), p.478-483</ispartof><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8745971$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Frikha, M</creatorcontrib><creatorcontrib>Montravers, P</creatorcontrib><creatorcontrib>Vogel, J</creatorcontrib><creatorcontrib>Enriquez, I</creatorcontrib><creatorcontrib>Nimier, M</creatorcontrib><creatorcontrib>Dureuil, B</creatorcontrib><creatorcontrib>Desmonts, J M</creatorcontrib><title>Severity scores underestimate the seriousness of acute renal failure after emergency surgery</title><title>Annales françaises d'anesthésie et de réanimation</title><addtitle>Ann Fr Anesth Reanim</addtitle><description>The predictive value of APACHE II and SAPS severity scores were evaluated in a group of patients with acute renal failure admitted in ICU after emergency surgery. The criteria of poor prognosis identified in the 24 hours following admission were also evaluated.
Open prospective study.
During 22 months, we included every patient admitted in ICU after emergency surgery with a serum creatinine concentration > or = 130 mumol.L-1. Clinical and biological parameters were collected in the first 24 hours following admission and the severity scores were calculated. Prediction of hospital outcome, based on APACHE II score, was calculated. The standard mortality ratio (observed mortality/predicted mortality) was calculated. Accuracy of SAPS and APACHE II score was compared using ROC curves and comparison of the areas under the curves.
Death in ICU occurred in 44% of the patients while hospital mortality was 51%. The standard mortality ratio for APACHE II score was 1.35. The areas under the curves for SAPS and APACHE II scores were not statistically different. The criteria of poor prognosis, identified in the first 24 hours following admission, were cardiovascular failure, oliguria and sepsis.
Conventional severity scores are inaccurate for prediction of mortality in patients with acute renal failure following emergency surgery.</description><subject>Acute Kidney Injury - diagnosis</subject><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - mortality</subject><subject>Acute Kidney Injury - physiopathology</subject><subject>Critical Care</subject><subject>Emergencies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - mortality</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><issn>0750-7658</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNotUEtLxDAYzEFZ1939CUJO3gp5NulRFl-wsAf3KJQ0-aKVvkwaof_eiL3MDMwwzPddoS1RkhSqlPoG3cb4RQiRXNAN2mglZKXoFr2_wQ-Edl5wtGOAiNPgIPPc9mYGPH8CjtkfUxwgRjx6bGzKRoDBdNibtksBsPEzBAw9hA8YbO5KWYRlj6696SIcVt6hy9Pj5fhSnM7Pr8eHUzFJTgupiTPOOyq0oCWjrjFcOVaJqnHaEi4lNVbL0mf0jWVV6QhjQhIolTWS8R26_6-dwvid8va6b6OFrjMD5OG1UhURTP8F79Zganpw9RTylWGp12_wX9IfXFI</recordid><startdate>1995</startdate><enddate>1995</enddate><creator>Frikha, M</creator><creator>Montravers, P</creator><creator>Vogel, J</creator><creator>Enriquez, I</creator><creator>Nimier, M</creator><creator>Dureuil, B</creator><creator>Desmonts, J M</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>1995</creationdate><title>Severity scores underestimate the seriousness of acute renal failure after emergency surgery</title><author>Frikha, M ; Montravers, P ; Vogel, J ; Enriquez, I ; Nimier, M ; Dureuil, B ; Desmonts, J M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p531-580dadfd14841621dba37d2949bd8c03551ac856fac8fbc296d022450e67ca523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>fre</language><creationdate>1995</creationdate><topic>Acute Kidney Injury - diagnosis</topic><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - mortality</topic><topic>Acute Kidney Injury - physiopathology</topic><topic>Critical Care</topic><topic>Emergencies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - mortality</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><toplevel>online_resources</toplevel><creatorcontrib>Frikha, M</creatorcontrib><creatorcontrib>Montravers, P</creatorcontrib><creatorcontrib>Vogel, J</creatorcontrib><creatorcontrib>Enriquez, I</creatorcontrib><creatorcontrib>Nimier, M</creatorcontrib><creatorcontrib>Dureuil, B</creatorcontrib><creatorcontrib>Desmonts, J M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Annales françaises d'anesthésie et de réanimation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Frikha, M</au><au>Montravers, P</au><au>Vogel, J</au><au>Enriquez, I</au><au>Nimier, M</au><au>Dureuil, B</au><au>Desmonts, J M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Severity scores underestimate the seriousness of acute renal failure after emergency surgery</atitle><jtitle>Annales françaises d'anesthésie et de réanimation</jtitle><addtitle>Ann Fr Anesth Reanim</addtitle><date>1995</date><risdate>1995</risdate><volume>14</volume><issue>6</issue><spage>478</spage><epage>483</epage><pages>478-483</pages><issn>0750-7658</issn><abstract>The predictive value of APACHE II and SAPS severity scores were evaluated in a group of patients with acute renal failure admitted in ICU after emergency surgery. The criteria of poor prognosis identified in the 24 hours following admission were also evaluated.
Open prospective study.
During 22 months, we included every patient admitted in ICU after emergency surgery with a serum creatinine concentration > or = 130 mumol.L-1. Clinical and biological parameters were collected in the first 24 hours following admission and the severity scores were calculated. Prediction of hospital outcome, based on APACHE II score, was calculated. The standard mortality ratio (observed mortality/predicted mortality) was calculated. Accuracy of SAPS and APACHE II score was compared using ROC curves and comparison of the areas under the curves.
Death in ICU occurred in 44% of the patients while hospital mortality was 51%. The standard mortality ratio for APACHE II score was 1.35. The areas under the curves for SAPS and APACHE II scores were not statistically different. The criteria of poor prognosis, identified in the first 24 hours following admission, were cardiovascular failure, oliguria and sepsis.
Conventional severity scores are inaccurate for prediction of mortality in patients with acute renal failure following emergency surgery.</abstract><cop>France</cop><pmid>8745971</pmid><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0750-7658 |
| ispartof | Annales françaises d'anesthésie et de réanimation, 1995, Vol.14 (6), p.478-483 |
| issn | 0750-7658 |
| language | fre |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acute Kidney Injury - diagnosis Acute Kidney Injury - etiology Acute Kidney Injury - mortality Acute Kidney Injury - physiopathology Critical Care Emergencies Female Humans Male Middle Aged Postoperative Complications - mortality Predictive Value of Tests Prognosis Prospective Studies Risk Assessment Severity of Illness Index |
| title | Severity scores underestimate the seriousness of acute renal failure after emergency surgery |
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