A modified sequential organ failure assessment score to predict hospital mortality of postoperative acute renal failure patients requiring renal replacement therapy.
BACKGROUND
A predictive model for hospital mortality in postoperative acute renal failure (ARF) patients requiring renal replacement therapy (RRT) may aid clinicians' therapeutic decision-making and research design.


METHODS
A prospective observational study of 398 postoperative ARF patients requiring RRT was conducted in four hospitals. The derivation cohort consisted of 334 patients recruited between January 2002 and December 2005. The validation cohort consisted of 64 patients recruited between January 2006 and December 2006.


RESULTS
The hospital mortality rates for the derivation and validation cohorts were 65.6 and 62.5%, respectively. A modified Sequential Organ Failure Assessment (SOFA) score was constructed at the commencement of RRT by a formula of serum lactate level (mM) + 2 x (generic SOFA score) + 3 x (age per decade) + 8 (if mechanical circulatory support required) + 10 (if total parenteral nutrition required) + 11 (if status postcardiopulmonary resuscitation) + 13 (if positive sepsis sign). The area under the receiver operating characteristic curve of the model for the derivation and validation cohorts was 0.804 and 0.839, respectively.


CONCLUSIONS
This validated score at dialysis commencement might assist clinicians in estimating hospital mortality, planning future clinical trials, and providing quantitative guidance for decision making in postoperative ARF patients requiring RRT.
Lin
Yu-Feng
YF
Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taipei, Taiwan, ROC.
Ko
Wen-Je
WJ
Wu
Vin-Cent
VC
Chen
Yih-Sharng
YS
Chen
Yung-Ming
YM
Hu
Fu-Chang
FC
Shiao
Chih-Chung
CC
Wu
Ming-Shiou
MS
Chen
Yung-Wei
YW
Li
Wen-Yi
WY
Huang
Tao-Min
TM
Wu
Kwan-Dun
KD
Chu
Tzong-Shinn
TS
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult