title: Outcome of patients with end stage renal disease admitted to an intensive care unit in India.
abstract: OBJECTIVE
  We sought to determine outcome and evaluate performance of Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores upon admission in predicting 30-day mortality of end-stage renal disease (ESRD) patients admitted in ICU.
  
  
  METHODS
  This prospective observational cohort study examined 73 consecutive ESRD patients admitted in an ICU of a tertiary care institute over 15 months. Primary outcome measure was 30-day mortality. Data on patient characteristics, reason for ICU admission, cause of ESRD, mode of renal replacement, and use of mechanical ventilation (MV) or inotropes were recorded. The APACHE 2 and SOFA scores were calculated based on admission characteristics.
  
  
  RESULTS
  First-day median APACHE II, SOFA, and APACHE II-predicted hospital mortality rates were 26 (14-49), 7 (4-17), and 56.9% (18.6-97.4%), respectively. Observed ICU and 30-day mortality rates were 27.4%, and 41.1%, respectively. During the ICU course, MV and inotropic support was required in 27 (37%) and 23 (35.1%) patients, respectively. Need for MV (p < 0.001) and inotropic support (p < 0.001) were predictors of 30-day mortality in univariate analysis. Area under receiver operating characteristic curve for APACHE II in predicting 30-day mortality was 0.86 (95% CI, 0.76-0.93) compared with 0.92 (95% CI, 0.83-0.97) for SOFA score (p = 0.16).
  
  
  CONCLUSIONS
  Outcome of ESRD patients admitted to ICU is poor, especially if they require other organ support. APACHE II and SOFA scores perform well as predictors of 30-day mortality.
authors.affiliation: Department of Anaesthesia and Critical Care Medicine, Global Hospital, Lakdi-ka-pul, Hyderabad, Andhra Pradesh, India. devenjuneja@gmail.com
authors.forename: Deven
authors.initials: D
authors.lastname: Juneja
authors.forename: Mayoor V
authors.initials: MV
authors.lastname: Prabhu
authors.forename: Palepu B
authors.initials: PB
authors.lastname: Gopal
authors.forename: S
authors.initials: S
authors.lastname: Mohan
authors.forename: G
authors.initials: G
authors.lastname: Sridhar
authors.forename: K S
authors.initials: KS
authors.lastname: Nayak
mesh_terms: D018806:APACHE; D005260:Female; D006801:Humans; D007194:India; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome