title: [APACHE II and ATN-ISS in acute renal failure (ARF) in intensive care unit (ICU) and non-ICU].
abstract: 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.
authors.affiliation: Universidade Federal de Juiz de Fora-UFJF, Juiz de Fora, MG, Brazil.
authors.forename: Natáia Maria da Silva
authors.initials: NM
authors.lastname: Fernandes
authors.forename: Patrícia dos Santos
authors.initials: Pdos S
authors.lastname: Pinto
authors.forename: Thiago Bento de Paiva
authors.initials: TB
authors.lastname: Lacet
authors.forename: Dominique Fonseca
authors.initials: DF
authors.lastname: Rodrigues
authors.forename: Marcus Gomes
authors.initials: MG
authors.lastname: Bastos
authors.forename: Sérgio Reinaldo
authors.initials: SR
authors.lastname: Stella
authors.forename: Miguel
authors.initials: M
authors.lastname: Cendoroglo Neto
mesh_terms: 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