The BEST (Beginning and Ending Supportive Therapy) Kidney Investigators identified a number of risk factors associated with mortality in a critically ill patient with acute renal failure. These can help identify a patient who may benefit from more aggressive management. The authors are from multiple institutions from North America, Europe, Australia, and Asia.
Patient selection: critically ill patient with acute renal failure
Risk factors for hospital mortality:
which indicates
(1) use of vasopressors
hypotension and shock
(2) septic shock
bacteremia and shock
(3) cardiogenic shock
cardiac failure
(4) mechanical ventilation
respiratory failure
(5) hepatorenal failure
cirrhosis/hepatic failure
where:
• The odds ratio for each item range from 1.4 to 2.1.
number of risk factors present =
= SUM(number of risk factors present)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• The risk of mortality increases as the number of organ failures increase.
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