Prognosis of ARF in hospitalized elderly patients

Ricardo Sesso, Alexandre Roque, Belinda Vicioso, Sergio Stella

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: Differentiation between hospital-acquired acute renal failure (ARF) and community-acquired ARF may have epidemiological implications that lead to different prognoses in hospitalized patients. Such a comparison has not yet been made among elderly individuals. Methods: We performed a 3-year prospective study in a tertiary referral hospital of 325 patients aged 60 years or older who presented with ARF. Patients were divided into 2 groups; those with hospital-acquired ARF (n = 154) and community-acquired ARF (n = 171), and were followed up in relation to mortality. Multiple logistic regression was used in the analysis. Results: The overall mortality rate in this elderly population was 54%; 59% for the group with hospital-acquired ARF and 41% for the group with community-acquired ARF (P < 0.001). Groups differed (P < 0.01) in relation to cause of ARF, preexisting diseases, organ failure, sepsis, and performance of dialysis, among other factors. The adjusted mortality risk for the group with hospital-acquired ARF was 2.23 times greater than for the group with community-acquired ARF (95% confidence interval [CI], 1.21 to 4.08). In the group with hospital-acquired ARF, factors associated with mortality were neurological failure (odds ratio [OR], 2.97; 95% CI, 1.17 to 7.60), hematologic failure (OR, 4.30; 95% CI, 1.63 to 11.34), and oliguria (OR, 12.14; 95% CI, 4.62 to 31.87). In the group with community-acquired ARF, significant factors were neoplasia, cardiac disease, hepatic disease, cardiovascular failure, oliguria, and sepsis. Conclusion: Differentiation between hospital-acquired ARF and community-acquired ARF is important in determining the prognosis of ARF in the elderly. Mortality risk factors are different in these 2 groups, and knowledge of their characteristics may allow better management of such patients.

Original languageEnglish (US)
Pages (from-to)410-419
Number of pages10
JournalAmerican Journal of Kidney Diseases
Volume44
Issue number3
DOIs
StatePublished - Sep 2004

Fingerprint

Acute Kidney Injury
Mortality
Confidence Intervals
Oliguria
Odds Ratio
Sepsis
Preexisting Condition Coverage
Tertiary Care Centers
Dialysis
Heart Diseases
Cardiovascular Diseases
Logistic Models

Keywords

  • Acute renal failure (ARF)
  • community acquired
  • elderly
  • hospital acquired
  • mortality

ASJC Scopus subject areas

  • Nephrology

Cite this

Prognosis of ARF in hospitalized elderly patients. / Sesso, Ricardo; Roque, Alexandre; Vicioso, Belinda; Stella, Sergio.

In: American Journal of Kidney Diseases, Vol. 44, No. 3, 09.2004, p. 410-419.

Research output: Contribution to journalArticle

Sesso, Ricardo ; Roque, Alexandre ; Vicioso, Belinda ; Stella, Sergio. / Prognosis of ARF in hospitalized elderly patients. In: American Journal of Kidney Diseases. 2004 ; Vol. 44, No. 3. pp. 410-419.
@article{b4e2fd2c7046461ea340559acbd8cc07,
title = "Prognosis of ARF in hospitalized elderly patients",
abstract = "Background: Differentiation between hospital-acquired acute renal failure (ARF) and community-acquired ARF may have epidemiological implications that lead to different prognoses in hospitalized patients. Such a comparison has not yet been made among elderly individuals. Methods: We performed a 3-year prospective study in a tertiary referral hospital of 325 patients aged 60 years or older who presented with ARF. Patients were divided into 2 groups; those with hospital-acquired ARF (n = 154) and community-acquired ARF (n = 171), and were followed up in relation to mortality. Multiple logistic regression was used in the analysis. Results: The overall mortality rate in this elderly population was 54{\%}; 59{\%} for the group with hospital-acquired ARF and 41{\%} for the group with community-acquired ARF (P < 0.001). Groups differed (P < 0.01) in relation to cause of ARF, preexisting diseases, organ failure, sepsis, and performance of dialysis, among other factors. The adjusted mortality risk for the group with hospital-acquired ARF was 2.23 times greater than for the group with community-acquired ARF (95{\%} confidence interval [CI], 1.21 to 4.08). In the group with hospital-acquired ARF, factors associated with mortality were neurological failure (odds ratio [OR], 2.97; 95{\%} CI, 1.17 to 7.60), hematologic failure (OR, 4.30; 95{\%} CI, 1.63 to 11.34), and oliguria (OR, 12.14; 95{\%} CI, 4.62 to 31.87). In the group with community-acquired ARF, significant factors were neoplasia, cardiac disease, hepatic disease, cardiovascular failure, oliguria, and sepsis. Conclusion: Differentiation between hospital-acquired ARF and community-acquired ARF is important in determining the prognosis of ARF in the elderly. Mortality risk factors are different in these 2 groups, and knowledge of their characteristics may allow better management of such patients.",
keywords = "Acute renal failure (ARF), community acquired, elderly, hospital acquired, mortality",
author = "Ricardo Sesso and Alexandre Roque and Belinda Vicioso and Sergio Stella",
year = "2004",
month = "9",
doi = "10.1053/j.ajkd.2004.05.022",
language = "English (US)",
volume = "44",
pages = "410--419",
journal = "American Journal of Kidney Diseases",
issn = "0272-6386",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Prognosis of ARF in hospitalized elderly patients

AU - Sesso, Ricardo

AU - Roque, Alexandre

AU - Vicioso, Belinda

AU - Stella, Sergio

PY - 2004/9

Y1 - 2004/9

N2 - Background: Differentiation between hospital-acquired acute renal failure (ARF) and community-acquired ARF may have epidemiological implications that lead to different prognoses in hospitalized patients. Such a comparison has not yet been made among elderly individuals. Methods: We performed a 3-year prospective study in a tertiary referral hospital of 325 patients aged 60 years or older who presented with ARF. Patients were divided into 2 groups; those with hospital-acquired ARF (n = 154) and community-acquired ARF (n = 171), and were followed up in relation to mortality. Multiple logistic regression was used in the analysis. Results: The overall mortality rate in this elderly population was 54%; 59% for the group with hospital-acquired ARF and 41% for the group with community-acquired ARF (P < 0.001). Groups differed (P < 0.01) in relation to cause of ARF, preexisting diseases, organ failure, sepsis, and performance of dialysis, among other factors. The adjusted mortality risk for the group with hospital-acquired ARF was 2.23 times greater than for the group with community-acquired ARF (95% confidence interval [CI], 1.21 to 4.08). In the group with hospital-acquired ARF, factors associated with mortality were neurological failure (odds ratio [OR], 2.97; 95% CI, 1.17 to 7.60), hematologic failure (OR, 4.30; 95% CI, 1.63 to 11.34), and oliguria (OR, 12.14; 95% CI, 4.62 to 31.87). In the group with community-acquired ARF, significant factors were neoplasia, cardiac disease, hepatic disease, cardiovascular failure, oliguria, and sepsis. Conclusion: Differentiation between hospital-acquired ARF and community-acquired ARF is important in determining the prognosis of ARF in the elderly. Mortality risk factors are different in these 2 groups, and knowledge of their characteristics may allow better management of such patients.

AB - Background: Differentiation between hospital-acquired acute renal failure (ARF) and community-acquired ARF may have epidemiological implications that lead to different prognoses in hospitalized patients. Such a comparison has not yet been made among elderly individuals. Methods: We performed a 3-year prospective study in a tertiary referral hospital of 325 patients aged 60 years or older who presented with ARF. Patients were divided into 2 groups; those with hospital-acquired ARF (n = 154) and community-acquired ARF (n = 171), and were followed up in relation to mortality. Multiple logistic regression was used in the analysis. Results: The overall mortality rate in this elderly population was 54%; 59% for the group with hospital-acquired ARF and 41% for the group with community-acquired ARF (P < 0.001). Groups differed (P < 0.01) in relation to cause of ARF, preexisting diseases, organ failure, sepsis, and performance of dialysis, among other factors. The adjusted mortality risk for the group with hospital-acquired ARF was 2.23 times greater than for the group with community-acquired ARF (95% confidence interval [CI], 1.21 to 4.08). In the group with hospital-acquired ARF, factors associated with mortality were neurological failure (odds ratio [OR], 2.97; 95% CI, 1.17 to 7.60), hematologic failure (OR, 4.30; 95% CI, 1.63 to 11.34), and oliguria (OR, 12.14; 95% CI, 4.62 to 31.87). In the group with community-acquired ARF, significant factors were neoplasia, cardiac disease, hepatic disease, cardiovascular failure, oliguria, and sepsis. Conclusion: Differentiation between hospital-acquired ARF and community-acquired ARF is important in determining the prognosis of ARF in the elderly. Mortality risk factors are different in these 2 groups, and knowledge of their characteristics may allow better management of such patients.

KW - Acute renal failure (ARF)

KW - community acquired

KW - elderly

KW - hospital acquired

KW - mortality

UR - http://www.scopus.com/inward/record.url?scp=4444268978&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4444268978&partnerID=8YFLogxK

U2 - 10.1053/j.ajkd.2004.05.022

DO - 10.1053/j.ajkd.2004.05.022

M3 - Article

C2 - 15332213

AN - SCOPUS:4444268978

VL - 44

SP - 410

EP - 419

JO - American Journal of Kidney Diseases

JF - American Journal of Kidney Diseases

SN - 0272-6386

IS - 3

ER -