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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