title: Using acute kidney injury severity and scoring systems to predict outcome in patients with burn injury.
abstract: OBJECTIVE
  Acute kidney injury (AKI) is a frequent complication of severe burn injury and is associated with mortality. The definition of AKI was modified by the Kidney Disease Improving Global Outcomes Group in 2012. So far, no study has compared the outcome accuracy of the new AKI staging guidelines with that of the complex score system. Hence, we compared the accuracy of these approaches in predicting mortality.
  
  
  METHODS
  This was a post hoc analysis of prospectively collected data from an intensive care burn unit in a tertiary care university hospital. Patients admitted to this unit from July 2004 to December 2006 were enrolled. Demographic, clinical, and laboratory data and prognostic risk scores were used as predictors of mortality.
  
  
  RESULTS
  A total of 145 adult patients with a mean age of 41.9 years were studied. Thirty-five patients (24.1%) died during the hospital course. Among the prognostic risk models, the Acute Physiology and Chronic Health Evaluation III system exhibited the strongest discriminative power and the AKI staging system also predicted mortality well (areas under the receiver operating characteristic curve: 0.889 vs. 0.835). Multivariate logistic regression analysis identified total burn surface area, ventilator use, AKI, and toxic epidermal necrolysis as independent risk factors for mortality.
  
  
  CONCLUSIONS
  Our results revealed that AKI stage has considerable discriminative power for predicting mortality. Compared with other prognostic models, AKI stage is easier to use to assess outcome in patients with severe burn injury.
authors.affiliation: Department of Nephrology, Kidney Research Center, Taoyuan City, Taiwan.
authors.forename: George
authors.initials: G
authors.lastname: Kuo
authors.affiliation: Department of Plastic Surgery, Linkou Burn Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Yang
authors.affiliation: Department of Plastic Surgery, Linkou Burn Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Shiow-Shuh
authors.initials: SS
authors.lastname: Chuang
authors.affiliation: Department of Nephrology, Kidney Research Center, Taoyuan City, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Fan
authors.affiliation: Department of Nephrology, Kidney Research Center, Taoyuan City, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chih-Hsiang
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Department of Plastic Surgery, Linkou Burn Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Yen-Chang
authors.initials: YC
authors.lastname: Hsiao
authors.affiliation: Department of Nephrology, Kidney Research Center, Taoyuan City, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: cyc2356@adm.cgmh.org.tw.
authors.forename: Yung-Chang
authors.initials: YC
authors.lastname: Chen
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality*; D000328:Adult; D002056:Burns / Q000150:complications* / Q000401:mortality; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: Acute Physiology and Chronic Health Evaluation; Sequential Organ Failure Assessment; acute kidney injury; burn; prognosis