A clinical score to predict mortality in septic acute kidney injury patients requiring continuous renal replacement therapy: the HELENICC score.
BACKGROUND
This study aimed to identify predictors of early (7-day) mortality in patients with septic acute kidney injury (AKI) who required continuous renal replacement therapy (CRRT).


METHODS
Prospective cohort of 186 septic AKI patients undergoing CRRT at a tertiary hospital, from October 2005 to November 2010.


RESULTS
After multivariate adjustment, five variables were associated to early mortality: norepinephrine utilization, liver failure, medical condition, lactate level, and pre-dialysis creatinine level. These variables were combined in a score, which demonstrated good discrimination, with a C-statistic of 0.82 (95% CI = 0.76-0.88), and good calibration (χ2= 4.3; p = 0.83). SAPS 3, APACHE II and SOFA scores demonstrated poor performance in this population.


CONCLUSIONS
The HEpatic failure, LactatE, NorepInephrine, medical Condition, and Creatinine (HELENICC) score outperformed tested generic models. Future studies should further validate this score in different cohorts.
Hospital Português, Salvador, Brazil. oiregorpassos@yahoo.com.br.|Hospital São Rafael, Salvador, Brazil. oiregorpassos@yahoo.com.br.
Rogério
R
da Hora Passos
Hospital São Rafael, Salvador, Brazil.
João Gabriel Rosa
JG
Ramos
Hospital Português, Salvador, Brazil.
Evandro Jose Bulhoes
EJ
Mendonça
Hospital Português, Salvador, Brazil.
Eva Alves
EA
Miranda
Hospital Português, Salvador, Brazil.
Fábio Ricardo Dantas
FR
Dutra
Hospital Português, Salvador, Brazil.
Maria Fernanda R
MF
Coelho
Hospital Português, Salvador, Brazil.
Andrea C
AC
Pedroza
Hospital São Rafael, Salvador, Brazil.
Luis Claudio L
LC
Correia
Hospital São Rafael, Salvador, Brazil.
Paulo Benigno Pena
PB
Batista
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Etienne
E
Macedo
Hospital Português, Salvador, Brazil.
Margarida M D
MM
Dutra
D058186:Acute Kidney Injury / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D017582:Renal Replacement Therapy; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality*; D012720:Severity of Illness Index
7-day mortality; Hemodiafiltration; Risk score; Septic acute kidney injury