Epidemiology and prognostic factors of critically ill patients treated with hemodiafiltration. Soubrier, S., Leroy, O., Devos, P., Nseir, S., Georges, H., d'Escrivan , T., & Guery, B. Journal of critical care, 21(1):66–72, March, 2006. doi abstract bibtex PURPOSE: The objective of this study is to study the epidemiology, outcome, and prognostic factors of critically ill patients treated with continuous venovenous hemodiafiltration (CVVHDF). MATERIALS AND METHODS: Observational cohort was done in a French 16-bed intensive care unit (ICU) from a university-affiliated urban hospital. All patients requiring, in the opinion of the treating physician, the initiation of CVVHDF were included in the study. RESULTS: One hundred ninety-seven patients with acute renal failure (ARF) treated with CVVHDF were studied. The incidence of ARF treated with CVVHDF was 5.9% in the ICU with a mortality rate of 71.6%. A multivariate analysis identified 3 independent factors associated with fatal outcome: mechanical ventilation, sepsis, and septic shock requiring vasoactive drug. In contrast, 2 independent factors predicted a favorable outcome: nonoliguric ARF and serum creatinine concentration higher than 34 mg/L at CVVHDF initiation. A flowchart determined by the chi2 Automatic Interaction and Detection statistical method allowed for the identification of patients' subgroups with different mortality rates ranging from 25% to 100%. CONCLUSIONS: In our series, ARF treated with CVVHDF was associated with a high overall ICU mortality rate (71.6%). However, our prognostic flowchart identified patients with low mortality rates for which renal replacement therapy must be initiated with no discussion as soon as required.
@article{soubrier_epidemiology_2006,
title = {Epidemiology and prognostic factors of critically ill patients treated with hemodiafiltration.},
volume = {21},
issn = {0883-9441 0883-9441},
doi = {10.1016/j.jcrc.2005.08.004},
abstract = {PURPOSE: The objective of this study is to study the epidemiology, outcome, and prognostic factors of critically ill patients treated with continuous venovenous hemodiafiltration (CVVHDF). MATERIALS AND METHODS: Observational cohort was done in a French 16-bed intensive care unit (ICU) from a university-affiliated urban hospital. All patients requiring, in the opinion of the treating physician, the initiation of CVVHDF were included in the study. RESULTS: One hundred ninety-seven patients with acute renal failure (ARF) treated with CVVHDF were studied. The incidence of ARF treated with CVVHDF was 5.9\% in the ICU with a mortality rate of 71.6\%. A multivariate analysis identified 3 independent factors associated with fatal outcome: mechanical ventilation, sepsis, and septic shock requiring vasoactive drug. In contrast, 2 independent factors predicted a favorable outcome: nonoliguric ARF and serum creatinine concentration higher than 34 mg/L at CVVHDF initiation. A flowchart determined by the chi2 Automatic Interaction and Detection statistical method allowed for the identification of patients' subgroups with different mortality rates ranging from 25\% to 100\%. CONCLUSIONS: In our series, ARF treated with CVVHDF was associated with a high overall ICU mortality rate (71.6\%). However, our prognostic flowchart identified patients with low mortality rates for which renal replacement therapy must be initiated with no discussion as soon as required.},
language = {eng},
number = {1},
journal = {Journal of critical care},
author = {Soubrier, Stephane and Leroy, Olivier and Devos, Patrick and Nseir, Saad and Georges, Hugues and d'Escrivan, Thibaud and Guery, Benoit},
month = mar,
year = {2006},
pmid = {16616626},
keywords = {France/epidemiology, Humans, Female, Aged, Male, Prognosis, Retrospective Studies, Chi-Square Distribution, Multivariate Analysis, Outcome Assessment (Health Care), *Hemodiafiltration, Incidence, *Critical Illness, Acute Kidney Injury/mortality/*therapy},
pages = {66--72}
}
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RESULTS: One hundred ninety-seven patients with acute renal failure (ARF) treated with CVVHDF were studied. The incidence of ARF treated with CVVHDF was 5.9% in the ICU with a mortality rate of 71.6%. A multivariate analysis identified 3 independent factors associated with fatal outcome: mechanical ventilation, sepsis, and septic shock requiring vasoactive drug. In contrast, 2 independent factors predicted a favorable outcome: nonoliguric ARF and serum creatinine concentration higher than 34 mg/L at CVVHDF initiation. A flowchart determined by the chi2 Automatic Interaction and Detection statistical method allowed for the identification of patients' subgroups with different mortality rates ranging from 25% to 100%. CONCLUSIONS: In our series, ARF treated with CVVHDF was associated with a high overall ICU mortality rate (71.6%). However, our prognostic flowchart identified patients with low mortality rates for which renal replacement therapy must be initiated with no discussion as soon as required.","language":"eng","number":"1","journal":"Journal of critical care","author":[{"propositions":[],"lastnames":["Soubrier"],"firstnames":["Stephane"],"suffixes":[]},{"propositions":[],"lastnames":["Leroy"],"firstnames":["Olivier"],"suffixes":[]},{"propositions":[],"lastnames":["Devos"],"firstnames":["Patrick"],"suffixes":[]},{"propositions":[],"lastnames":["Nseir"],"firstnames":["Saad"],"suffixes":[]},{"propositions":[],"lastnames":["Georges"],"firstnames":["Hugues"],"suffixes":[]},{"propositions":["d'Escrivan"],"lastnames":[],"firstnames":["Thibaud"],"suffixes":[]},{"propositions":[],"lastnames":["Guery"],"firstnames":["Benoit"],"suffixes":[]}],"month":"March","year":"2006","pmid":"16616626","keywords":"France/epidemiology, Humans, Female, Aged, Male, Prognosis, Retrospective Studies, Chi-Square Distribution, Multivariate Analysis, Outcome Assessment (Health Care), *Hemodiafiltration, Incidence, *Critical Illness, Acute Kidney Injury/mortality/*therapy","pages":"66–72","bibtex":"@article{soubrier_epidemiology_2006,\n\ttitle = {Epidemiology and prognostic factors of critically ill patients treated with hemodiafiltration.},\n\tvolume = {21},\n\tissn = {0883-9441 0883-9441},\n\tdoi = {10.1016/j.jcrc.2005.08.004},\n\tabstract = {PURPOSE: The objective of this study is to study the epidemiology, outcome, and prognostic factors of critically ill patients treated with continuous venovenous hemodiafiltration (CVVHDF). MATERIALS AND METHODS: Observational cohort was done in a French 16-bed intensive care unit (ICU) from a university-affiliated urban hospital. All patients requiring, in the opinion of the treating physician, the initiation of CVVHDF were included in the study. RESULTS: One hundred ninety-seven patients with acute renal failure (ARF) treated with CVVHDF were studied. The incidence of ARF treated with CVVHDF was 5.9\\% in the ICU with a mortality rate of 71.6\\%. A multivariate analysis identified 3 independent factors associated with fatal outcome: mechanical ventilation, sepsis, and septic shock requiring vasoactive drug. In contrast, 2 independent factors predicted a favorable outcome: nonoliguric ARF and serum creatinine concentration higher than 34 mg/L at CVVHDF initiation. A flowchart determined by the chi2 Automatic Interaction and Detection statistical method allowed for the identification of patients' subgroups with different mortality rates ranging from 25\\% to 100\\%. 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