[APACHE II and ATN-ISS in acute renal failure (ARF) in intensive care unit (ICU) and non-ICU].
BACKGROUND
Acute renal failure (ARF) remains highly prevalent with a high rate of morbidity and mortality.


OBJECTIVE
of this study was to compare use of the APACHE II scoring prognosis with that of the ATN-ISS to determine whether the APACHE II could be used for patients with ARF outside the ICU.


METHODS
For this purpose, 205 patients with ARF were accompanied in a prospective cohort. Demographic data, preexisting conditions, organ failure and characteristics of ARF were analyzed. The prognostic scores were performed with the assessment of a nephrologist.


RESULTS
The mean age was 52 +/- 18 years, 50% were male, 69% were white, 45% were treated in ICU and 55% in other units. Mortality in the ICU group was 85% and in the non-ICU group 18%. Factors that correlated with higher mortality were more prevalent in the ICU group: age, male, hospitalization with ARF, organ failure, sepsis, septic IRA, oliguria and need of dialysis. Overall, the prognostic markers were the same for both the ICU and non-ICU groups. The discrimination with the APACHE II was similar in both, ICU and non-ICU groups and calibration was better in the non-ICU group. The ATN-ISS achieved good discrimination in both the ICU and non-ICU groups, but, regarding calibration, there was a discreet over estimating of mortality in the non-ICU group. The ATN-ISS showed a greater capacity for discrimination than the APACHE II in both the ICU and non-ICU groups.


CONCLUSIONS
It was concluded that the APACHE II and ATN-ISS scores could be used for stratification of risk in patients with ARF treated outside of the ICU in Brazil.
Fernandes
Natáia Maria da Silva
NM
Universidade Federal de Juiz de Fora-UFJF, Juiz de Fora, MG, Brazil.
Pinto
Patrícia dos Santos
Pdos S
Lacet
Thiago Bento de Paiva
TB
Rodrigues
Dominique Fonseca
DF
Bastos
Marcus Gomes
MG
Stella
Sérgio Reinaldo
SR
Cendoroglo Neto
Miguel
M
D018806:APACHE; D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011379:Prognosis