Acute renal injury in patients with severe sepsis: prognostic factors <br><b>Abstract in English]</b>

  • Thábata Yaedu Okamoto Universidade Estadual de Londrina
  • Jéssica Christiane Yoshihara Dias Universidade Estadual de Londrina
  • Priscila Taguti Universidade Estadual de Londrina
  • Maria Fernanda Sacon Universidade Estadual de Londrina
  • Ivanil Aparecida Moro Kauss Universidade Estadual de Londrina
  • Claudia Maria Dantas de Maio Carrilho Universidade Estadual de Londrina
  • Lucienne Tibery Queiroz Cardoso Universidade Estadual de Londrina
  • Cintia Magalhães Carvalho Grion Universidade Estadual de Londrina
  • Tiemi Matsuo Universidade Estadual de Londrina
Keywords: SEPSIS, RENAL INDUFFICIENCY, MULTIPLE ORGAN FAILURE, MORTALITY, RISK FACTORS.

Abstract

AIMS: To investigate the determinants of prognosis in patients with severe sepsis and acute renal failure. METHODS: We included all patients older than 18 years admitted to the intensive care unit of University Hospital of Londrina (Paraná state) between May 2007 and June 2008 with a diagnosis of severe sepsis or septic shock. RESULTS: We analyzed 67 patients, whose average age was 61±18 years; 47 (70.1%) had acute renal failure and 18 (26.9%) required dialysis. Mortality was higher in patients with acute renal failure (85.1%) compared with patients without acute renal failure (35.0%, p less than 0.001). There was need for mechanical ventilation in 53 (79.1%) patients and vasoactive drugs in 51 (76.1%) patients. Risk factors that were associated with higher mortality in the bivariate analysis were the APACHE II score (p = 0.02), SOFA (p = 0.03), vasoactive drugs (p less than 0.01) and mechanical ventilation (p = 0.01). In multivariate analysis, vasoactive drugs remained significant, with OR of 25.33 (95% CI 3.21-199.69, p = 0.002). CONCLUSIONS: Acute renal failure was a common occurrence in patients with sepsis, as part of a framework of multiple organ systems and, particularly in patients with septic shock. Acute renal failure was associated with increased likelihood of death in these severely ill patients. Use of vasoactive drugs was the only risk factor for mortality in patients with sepsis and acute renal failure which remained in the multivariate analysis. These results point to the importance of early treatment of severe sepsis in time to prevent progression to septic shock and renal failure.

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Author Biographies

Thábata Yaedu Okamoto, Universidade Estadual de Londrina
Graduação em Medicina
Jéssica Christiane Yoshihara Dias, Universidade Estadual de Londrina
Graduação em Medicina
Priscila Taguti, Universidade Estadual de Londrina
Graduação em Medicina
Maria Fernanda Sacon, Universidade Estadual de Londrina
Graduação em Medicina
Ivanil Aparecida Moro Kauss, Universidade Estadual de Londrina
Fisioterapeuta Divisão de Terapia intensiva - Hospital Universitário
Claudia Maria Dantas de Maio Carrilho, Universidade Estadual de Londrina
Departamento de Clinica Médica - Ciências da Saúde
Lucienne Tibery Queiroz Cardoso, Universidade Estadual de Londrina
Departamento de Clinica Médica - Ciências da Saúde
Cintia Magalhães Carvalho Grion, Universidade Estadual de Londrina
Departamento de Clinica Médica - Ciências da Saúde
Tiemi Matsuo, Universidade Estadual de Londrina
Departamento de Estatística - Matemática
Published
2012-08-07
How to Cite
Okamoto, T. Y., Dias, J. C. Y., Taguti, P., Sacon, M. F., Kauss, I. A. M., Carrilho, C. M. D. de M., Cardoso, L. T. Q., Grion, C. M. C., & Matsuo, T. (2012). Acute renal injury in patients with severe sepsis: prognostic factors <br><b>Abstract in English]</b>. Scientia Medica, 22(3), 138-141. Retrieved from https://revistaseletronicas.pucrs.br/ojs/index.php/scientiamedica/article/view/10804
Section
Original Articles