Patient selection: acute postoperative liver failure complicated by acute renal failure
Outcome: mortality in ICU (seen in 66% of patients in the study)
Parameters associated with mortality:
(1) modality for providing renal replacement therapy
(2) APACHE II score prior to starting dialysis
(3) when dialysis started, based on serum BUN before dialysis initiated
|
Parameter
|
Finding
|
Points
|
|
renal replacement therapy
|
continuous venous-venous hemofiltration
|
0
|
|
|
intermittent hemodialysis
|
1
|
|
APACHE II score prior to dialysis
|
<= 20
|
0
|
|
|
> 20
|
1
|
|
initiation of dialysis
|
early (BUN < 80 mg/dL)
|
0
|
|
|
late (BUN >= 80 mg/dL)
|
1
|
where:
• The odds ratios for each item ranged from 4 to 6.5.
total number of risk factors =
= SUM(points for the 3 factors)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• The risk of ICU mortality increases with the number of risk factors present.
