caa a22 4500 475773934 CHVBK 20180406123625.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1023/A:1007177130883 doi (NATIONALLICENCE)springer-10.1023/A:1007177130883 Severity of illness scores and the outcome of acute tubular necrosis [Elektronische Daten] [Mohamed El-Shahawy, Lourdes Agbing, Emelie Badillo] The outcome of patients with acute renal failure (ARF)due to acute tubular necrosis (ATN) was evaluated inthis study. Two hundred and twenty-two patients witha mean age of 55.l ± 17.7 years (range 19-97years; male 153, female 69) who developed ATN in theperiod from July 1991 through January 1997 werestudied. Patients were divided into four groupsaccording to their APACHE II scores at the time of thediagnosis of ATN. Group I included patients with anAPACHE II score of 14 or less (n = 70), Group II with ascore of 15-18 (n = 52), Group III with a score of 19-23(n = 58), and group IV with a score of 24 or above(n = 42). The mean APACHE II score for each of the fourstudy groups was 11 ± 0.4, 16 ± 0.2, 20 ±0.2, and 29 ± 0.7, respectively. Patient survivalwas evaluated by the Kaplan-Meier analysis withcensorship at 12 months. Survival rates at 180 dayswere 67%, 47%, 39%, and zero%, for group I through IV respectively, χ2 = 27.99, p < 0.0001,with a median survival of >365, 120, 31, and 11days, for groups I through IV, respectively. For patients with oliguria (n = 88) survival at 180days was 23% vs. 58% for patients without oliguria(n = 134), p < 0.0001, median survival 13 vs. 364 d.Six months survival of those who required dialysis(n = 79) was 25% vs. 58% for those whom dialysis wasnot needed (n = 143), p = 0.001, median survival 15 vs.364 d, respectively. In patients with sepsis (n = 58),6 months survival was 35% vs. 50% for those withoutsepsis (n = 164), p = 0.013, median survival 14 vs. 169 d. In patients who required mechanical ventilation(n = 72), 6 months survival was 17% vs. 62% for those whodid not need respiratory support (n = 150), p = 0.0001,median survival 13 vs. > 365 d, respectively. Finally, 6 months survival in patients with one(kidney only), two, three, and four organ failure was76, 30, 11, and zero percent, respectively, p = 0.0001,median survival > 365, 16, 11, and 12 days,respectively. We conclude that the use of the APACHE II score forthe stratification of the severity of illness could beof clinical utility in predicting mortality inpatients with ATN. Other predictors of poor prognosisinclude the need for dialysis, the presence ofoliguria, the need for mechanical ventilation, thepresence of sepsis, and the number of failed organs. Kluwer Academic Publishers, 2000 Acute renal failure nationallicence Acute tubular necrosis nationallicence El-Shahawy Mohamed Division of Nephrology, Department of Medicine, University of Southern California School of Medicine, Los Angeles, California, USA aut Agbing Lourdes Division of Nephrology, Department of Medicine, University of Southern California School of Medicine, Los Angeles, California, USA aut Badillo Emelie Division of Nephrology, Department of Medicine, University of Southern California School of Medicine, Los Angeles, California, USA aut International Urology and Nephrology Kluwer Academic Publishers 32/2(2000-06-01), 185-191 0301-1623 32:2<185 2000 32 11255 https://doi.org/10.1023/A:1007177130883 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1007177130883 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- El-Shahawy Mohamed Division of Nephrology, Department of Medicine, University of Southern California School of Medicine, Los Angeles, California, USA aut NATIONALLICENCE 700 1- Agbing Lourdes Division of Nephrology, Department of Medicine, University of Southern California School of Medicine, Los Angeles, California, USA aut NATIONALLICENCE 700 1- Badillo Emelie Division of Nephrology, Department of Medicine, University of Southern California School of Medicine, Los Angeles, California, USA aut NATIONALLICENCE 773 0- International Urology and Nephrology Kluwer Academic Publishers 32/2(2000-06-01), 185-191 0301-1623 32:2<185 2000 32 11255 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer