title: Evaluation of prognostic indexes in critical acute renal failure patients.
abstract: OBJECTIVE
  To study different prognostic indexes in acute renal failure (ARF) patients admitted to an intensive care unit (ICU).
  
  
  METHODS
  Prospective, cohort study. Individual Severity Score-Acute Tubular Necrosis (ISS-ATN) obtained prospectively and retrospectively, Acute Physiologic and Chronic Health Evaluation (APACHE II) Score, APACHE II Risk, Lung Injury Score (LIS), and Number of Organ Failures (NOF) were calculated for each patient. The outcome analyzed was death in the ICU. Discrimination was evaluated by the area under the receiver operator characteristic curve (AUC). For calibration analysis, the chi-square goodness-of-fit test was used to compare predicted mortality, calculated by ISS-ATN (obtained prospectively or retrospectively) and APACHE II risk, with observed mortality.
  
  
  METHODS
  ICU, São Rafael Hospital, Salvador-BA, Brazil.
  
  
  METHODS
  Seventy-six ARF patients admitted to the ICU within 6 months.
  
  
  METHODS
  Surgical and medical procedures.
  
  
  RESULTS
  The observed AUC was 0.69 for LIS, 0.73 for prospective ISS-ATN, 0.75 for retrospective ISS-ATN, 0.76 for APACHE II Score, 0.78 for APACHE II Risk, and 0.88 for NOF. These areas were significantly different from 0.5 (p < .001). There was no difference between the observed and expected death rate calculated by ISS-ATN. However, APACHE II underestimated the observed mortality (p < .001).
  
  
  CONCLUSIONS
  The prognostic indexes studied showed good discriminative power. However, APACHE II was not well calibrated in contrast to the good calibration of ISS-ATN.
authors.affiliation: Nephrology and Hemodialysis Service, São Rafael Hospital, Salvador, Bahia, Brazil. pbenigno@terra.com.br
authors.forename: Paulo Benigno Pena
authors.initials: PB
authors.lastname: Batista
authors.forename: Miguel
authors.initials: M
authors.lastname: Cendorogolo Neto
authors.forename: Oscar Fernando Pavão
authors.initials: OF
authors.lastname: dos Santos
authors.forename: Ana Clarissa
authors.initials: AC
authors.lastname: Carvalho Bacelar
authors.forename: Gervásio
authors.initials: G
authors.lastname: Batista Campos
authors.forename: Elise Schaer Carvalho
authors.initials: ES
authors.lastname: dos Santos
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies