title: Advanced age affects the outcome-predictive power of RIFLE classification in geriatric patients with acute kidney injury.
abstract: The RIFLE (risk, injury, failure, loss, and end-stage) classification is widely used to gauge the severity of acute kidney injury, but its efficacy has not been formally tested in geriatric patients. To correct this we conducted a prospective observational study in a multicenter cohort of 3931 elderly patients (65 years of age or older) who developed acute kidney injury in accordance with the RIFLE creatinine criteria after major surgery. We studied the predictive power of the RIFLE classification for in-hospital mortality and investigated the potential interaction between age and RIFLE classification. In general, the survivors were significantly younger than the nonsurvivors and more likely to have hypertension. In patients 76 years of age and younger, RIFLE-R, -I, or -F classifications were significantly associated with increased hospital mortality in a stepwise manner. There was no significant difference, however, in hospital mortality in those over 76 years of age between patients with RIFLE-R and RIFLE-I, although RIFLE-F patients had significantly higher mortality than both groups. Thus, the less severe categorizations of acute kidney injury per RIFLE classification may not truly reflect the adverse impact on elderly patients.
authors: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Chia-Ter
authors: CT
authors: Chao
authors: Vin-Cent
authors: VC
authors: Wu
authors: Chun-Fu
authors: CF
authors: Lai
authors: Chih-Chung
authors: CC
authors: Shiao
authors: Tao-Min
authors: TM
authors: Huang
authors: Pei-Chen
authors: PC
authors: Wu
authors: I-Jung
authors: IJ
authors: Tsai
authors: Chun-Cheng
authors: CC
authors: Hou
authors: Wei-Jie
authors: WJ
authors: Wang
authors: Hung-Bin
authors: HB
authors: Tsai
authors: Yu-Feng
authors: YF
authors: Lin
authors: Wen-Chih
authors: WC
authors: Chiang
authors: Shuei-Liong
authors: SL
authors: Lin
authors: Pi-Ru
authors: PR
authors: Tsai
authors: Wen-Je
authors: WJ
authors: Ko
authors: Ming-Shiou
authors: MS
authors: Wu
authors: Kuan-Dun
authors: KD
authors: Wu
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000145:classification* / Q000401:mortality; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000145:classification / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology
chemical_list: D003404:Creatinine