Publication

Clinical examination findings as predictors of acute kidney injury in critically ill patients

SICS Study Grp, Wiersema, R. E., Koeze, J., Eck, R. J., Kaufmann, T., Hiemstra, B., Koster, G., Franssen, C. F. M., Vaara, S. T., Keus, F. & Van der Horst, I. C. C., 30-Sep-2019, In : Acta Anaesthesiologica Scandinavica. 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

SICS Study Grp, Wiersema, R. E., Koeze, J., Eck, R. J., Kaufmann, T., Hiemstra, B., Koster, G., Franssen, C. F. M., Vaara, S. T., Keus, F., & Van der Horst, I. C. C. (2019). Clinical examination findings as predictors of acute kidney injury in critically ill patients. Acta Anaesthesiologica Scandinavica. https://doi.org/10.1111/aas.13465

Author

SICS Study Grp ; Wiersema, Renske E. ; Koeze, Jacqueline ; Eck, Ruben J. ; Kaufmann, Thomas ; Hiemstra, Bart ; Koster, Geert ; Franssen, Casper F. M. ; Vaara, Suvi T. ; Keus, Frederik ; Van der Horst, Iwan C. C. / Clinical examination findings as predictors of acute kidney injury in critically ill patients. In: Acta Anaesthesiologica Scandinavica. 2019.

Harvard

SICS Study Grp, Wiersema, RE, Koeze, J, Eck, RJ, Kaufmann, T, Hiemstra, B, Koster, G, Franssen, CFM, Vaara, ST, Keus, F & Van der Horst, ICC 2019, 'Clinical examination findings as predictors of acute kidney injury in critically ill patients', Acta Anaesthesiologica Scandinavica. https://doi.org/10.1111/aas.13465

Standard

Clinical examination findings as predictors of acute kidney injury in critically ill patients. / SICS Study Grp ; Wiersema, Renske E.; Koeze, Jacqueline; Eck, Ruben J.; Kaufmann, Thomas; Hiemstra, Bart; Koster, Geert; Franssen, Casper F. M.; Vaara, Suvi T.; Keus, Frederik; Van der Horst, Iwan C. C.

In: Acta Anaesthesiologica Scandinavica, 30.09.2019.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

SICS Study Grp, Wiersema RE, Koeze J, Eck RJ, Kaufmann T, Hiemstra B et al. Clinical examination findings as predictors of acute kidney injury in critically ill patients. Acta Anaesthesiologica Scandinavica. 2019 Sep 30. https://doi.org/10.1111/aas.13465


BibTeX

@article{da56d0b8e00344adbf842568d20823b6,
title = "Clinical examination findings as predictors of acute kidney injury in critically ill patients",
abstract = "Background Acute Kidney Injury (AKI) in critically ill patients is associated with a markedly increased morbidity and mortality. The aim of this study was to establish the predictive value of clinical examination for AKI in critically ill patients. Methods This was a sub-study of the SICS-I, a prospective observational cohort study of critically ill patients acutely admitted to the Intensive Care Unit (ICU). Clinical examination was performed within 24 hours of ICU admission. The occurrence of AKI was determined at day two and three after admission according to the KDIGO definition including serum creatinine and urine output. Multivariable regression modeling was used to assess the value of clinical examination for predicting AKI, adjusted for age, comorbidities and the use of vasopressors. Results A total of 1003 of 1075 SICS-I patients (93%) were included in this sub-study. 414 of 1003 patients (41%) fulfilled the criteria for AKI. Increased heart rate (OR 1.12 per 10 beats per minute increase, 98.5% CI 1.04-1.22), subjectively cold extremities (OR 1.52, 98.5% CI 1.07-2.16) and a prolonged capillary refill time on the sternum (OR 1.89, 98.5% CI 1.01-3.55) were associated with AKI. This multivariable analysis yielded an area under the receiver-operating curve (AUROC) of 0.70 (98.5% CI 0.66-0.74). The model performed better when lactate was included (AUROC of 0.72, 95%CI 0.69-0.75), P = .04. Conclusion Clinical examination findings were able to predict AKI with moderate accuracy in a large cohort of critically ill patients. Findings of clinical examination on ICU admission may trigger further efforts to help predict developing AKI.",
keywords = "acute kidney injury, capillary refill time, clinical examination, critically ill, peripheral perfusion, PREVENTION, PERFUSION",
author = "{SICS Study Grp} and Wiersema, {Renske E.} and Jacqueline Koeze and Eck, {Ruben J.} and Thomas Kaufmann and Bart Hiemstra and Geert Koster and Franssen, {Casper F. M.} and Vaara, {Suvi T.} and Frederik Keus and {Van der Horst}, {Iwan C. C.}",
year = "2019",
month = sep,
day = "30",
doi = "10.1111/aas.13465",
language = "English",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Clinical examination findings as predictors of acute kidney injury in critically ill patients

AU - SICS Study Grp

AU - Wiersema, Renske E.

AU - Koeze, Jacqueline

AU - Eck, Ruben J.

AU - Kaufmann, Thomas

AU - Hiemstra, Bart

AU - Koster, Geert

AU - Franssen, Casper F. M.

AU - Vaara, Suvi T.

AU - Keus, Frederik

AU - Van der Horst, Iwan C. C.

PY - 2019/9/30

Y1 - 2019/9/30

N2 - Background Acute Kidney Injury (AKI) in critically ill patients is associated with a markedly increased morbidity and mortality. The aim of this study was to establish the predictive value of clinical examination for AKI in critically ill patients. Methods This was a sub-study of the SICS-I, a prospective observational cohort study of critically ill patients acutely admitted to the Intensive Care Unit (ICU). Clinical examination was performed within 24 hours of ICU admission. The occurrence of AKI was determined at day two and three after admission according to the KDIGO definition including serum creatinine and urine output. Multivariable regression modeling was used to assess the value of clinical examination for predicting AKI, adjusted for age, comorbidities and the use of vasopressors. Results A total of 1003 of 1075 SICS-I patients (93%) were included in this sub-study. 414 of 1003 patients (41%) fulfilled the criteria for AKI. Increased heart rate (OR 1.12 per 10 beats per minute increase, 98.5% CI 1.04-1.22), subjectively cold extremities (OR 1.52, 98.5% CI 1.07-2.16) and a prolonged capillary refill time on the sternum (OR 1.89, 98.5% CI 1.01-3.55) were associated with AKI. This multivariable analysis yielded an area under the receiver-operating curve (AUROC) of 0.70 (98.5% CI 0.66-0.74). The model performed better when lactate was included (AUROC of 0.72, 95%CI 0.69-0.75), P = .04. Conclusion Clinical examination findings were able to predict AKI with moderate accuracy in a large cohort of critically ill patients. Findings of clinical examination on ICU admission may trigger further efforts to help predict developing AKI.

AB - Background Acute Kidney Injury (AKI) in critically ill patients is associated with a markedly increased morbidity and mortality. The aim of this study was to establish the predictive value of clinical examination for AKI in critically ill patients. Methods This was a sub-study of the SICS-I, a prospective observational cohort study of critically ill patients acutely admitted to the Intensive Care Unit (ICU). Clinical examination was performed within 24 hours of ICU admission. The occurrence of AKI was determined at day two and three after admission according to the KDIGO definition including serum creatinine and urine output. Multivariable regression modeling was used to assess the value of clinical examination for predicting AKI, adjusted for age, comorbidities and the use of vasopressors. Results A total of 1003 of 1075 SICS-I patients (93%) were included in this sub-study. 414 of 1003 patients (41%) fulfilled the criteria for AKI. Increased heart rate (OR 1.12 per 10 beats per minute increase, 98.5% CI 1.04-1.22), subjectively cold extremities (OR 1.52, 98.5% CI 1.07-2.16) and a prolonged capillary refill time on the sternum (OR 1.89, 98.5% CI 1.01-3.55) were associated with AKI. This multivariable analysis yielded an area under the receiver-operating curve (AUROC) of 0.70 (98.5% CI 0.66-0.74). The model performed better when lactate was included (AUROC of 0.72, 95%CI 0.69-0.75), P = .04. Conclusion Clinical examination findings were able to predict AKI with moderate accuracy in a large cohort of critically ill patients. Findings of clinical examination on ICU admission may trigger further efforts to help predict developing AKI.

KW - acute kidney injury

KW - capillary refill time

KW - clinical examination

KW - critically ill

KW - peripheral perfusion

KW - PREVENTION

KW - PERFUSION

U2 - 10.1111/aas.13465

DO - 10.1111/aas.13465

M3 - Article

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

ER -

ID: 99697396