Journal article
Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability
Critical care medicine, Vol.44(12), pp.2241-2250
12/01/2016
DOI: 10.1097/CCM.0000000000002007
PMCID: PMC5267552
PMID: 27513354
Abstract
Objectives: The prevalence of septic acute kidney injury and impact on functional status of PICU survivors are unknown. We used data from an international prospective severe sepsis study to elucidate functional outcomes of children suffering septic acute kidney injury.
Design: Secondary analysis of patients in the Sepsis PRevalence, OUtcomes, and Therapies point prevalence study: acute kidney injury was defined on the study day using Kidney Disease Improving Global Outcomes definitions. Patients with no acute kidney injury or stage 1 acute kidney injury ("no/mild acute kidney injury") were compared with those with stage 2 or 3 acute kidney injury ("severe acute kidney injury"). The primary outcome was a composite of death or new moderate disability at discharge defined as a Pediatric Overall Performance Category score of 3 or higher and increased by 1 from baseline.
Setting: One hundred twenty-eight PICUs in 26 countries.
Patients: Children with severe sepsis in the Sepsis PRevalence, OUtcomes, and Therapies study.
Interventions: None.
Measurements and Main Results: One hundred two (21%) of 493 patients had severe acute kidney injury. More than twice as many patients with severe acute kidney injury died or developed new moderate disability compared with those with no/mild acute kidney injury (64% vs 30%; p < 0.001). Severe acute kidney injury was independently associated with death or new moderate disability (adjusted odds ratio, 2.5; 95% CI, 1.5-4.2; p = 0.001) after adjustment for age, region, baseline disability, malignancy, invasive mechanical ventilation, albumin administration, and the pediatric logistic organ dysfunction score.
Conclusions: In a multinational cohort of critically ill children with severe sepsis and high mortality rates, septic acute kidney injury is independently associated with further increased death or new disability.
Details
- Title: Subtitle
- Acute Kidney Injury in Pediatric Severe Sepsis: An Independent Risk Factor for Death and New Disability
- Creators
- Julie C. Fitzgerald - Children's Hospital of PhiladelphiaRajit K. Basu - Cincinnati Children's Hospital Medical CenterAyse Akcan-Arikan - Baylor College of MedicineLedys M. Izquierdo - Hospital Militar CentralByron E. Pineres Olave - Hospital Pablo Tobon UribeAmanda B. Hassinger - University at Buffalo, State University of New YorkMaria Szczepanska - University of Silesia in KatowiceAkash Deep - King's College HospitalDuane Williams - Virginia Commonwealth UniversityAnil Sapru - University of California, San FranciscoJason A. Roy - University of PennsylvaniaVinay M. Nadkarni - Children's Hospital of PhiladelphiaNeal J. Thomas - Pennsylvania State UniversityScott L. Weiss - Children's Hospital of PhiladelphiaSusan Furth - Children's Hospital of PhiladelphiaSepsis Prevalence, Outcomes, and Therapies (SPROUT) Study InvestigatorsPediatric Acute Lung Injury and Sepsis Investigators Network
- Contributors
- M Chegondi (Contributor) - University of Iowa, Stead Family Department of PediatricsC Tigges (Contributor) - University of Iowa, Critical Care
- Resource Type
- Journal article
- Publication Details
- Critical care medicine, Vol.44(12), pp.2241-2250
- DOI
- 10.1097/CCM.0000000000002007
- PMID
- 27513354
- PMCID
- PMC5267552
- NLM abbreviation
- Crit Care Med
- ISSN
- 0090-3493
- eISSN
- 1530-0293
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 10
- Grant note
- K12HD047349-10 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA CareFusion Center for Pediatric Clinical Effectiveness at The Children's Hospital of Philadelphia K12HD047349 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) Southampton NIHR Wellcome Trust Clinical Research Facility Endowed Chair, Department of Anesthesia and Critical Care, University of Pennsylvania Perelman School of Medicine K23GM110496 / NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS) Therabron National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Food and Drug Administration; United States Department of Health & Human Services Thermo-Fisher Scientific Children's Hospital of Philadelphia Center for Pediatric Clinical Effectiveness Baxter U.K. National Institute of Health (NIHR) Clinical Research Network
- Language
- English
- Date published
- 12/01/2016
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics
- Record Identifier
- 9984353836702771
Metrics
22 Record Views