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Rifle classification for predicting in-hospital mortality in critically ill sepsis patients.
Shock. 2009 Feb; 31(2):139-45.S

Abstract

Severe sepsis and septic shock, often complicated by acute kidney injury (AKI), are the most common causes of mortality in noncoronary intensive care units (ICUs). This study investigates the outcomes of critically ill patients with sepsis and elucidates the association between prognosis and risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage renal failure (RIFLE) classification. A total of 121 sepsis patients were admitted to ICU from June 2003 to January 2004. Forty-seven demographic, clinical, and laboratory variables were prospectively recorded for post hoc analysis as predictors of survival on the first day of ICU admission. Overall in-hospital mortality rate was 47.9%. Mortality was significantly associated (chi-square for trend; P < 0.001) with RIFLE classification. Septic shock, RIFLE category, and number of organ system failures on the first day of ICU admission were independent predictors of hospital mortality according to forward conditional logistic regression. The severity of RIFLE classification correlated with organ system failure number and Acute Physiology and Chronic Health Evaluation (APACHE) II to IV and sequential organ failure assessment scores. Cumulative survival rates at 6-month follow-up after hospital discharge significantly (P < 0.05) differed between non-AKI versus RIFLE injury, non-AKI versus RIFLE failure (RIFLE-F), and RIFLE risk versus RIFLE F. At 6-month follow-up, full recovery of renal function was noted in 85% of surviving patients with AKI (RIFLE risk, RIFLE injury, and RIFLE-F). In conclusion, these findings are consistent with a role for RIFLE classification in accurately predicting in-hospital mortality and short-term prognosis in ICU sepsis patients.

Authors+Show Affiliations

Departments of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan. smlin100@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18520698

Citation

Chen, Yung-Chang, et al. "Rifle Classification for Predicting In-hospital Mortality in Critically Ill Sepsis Patients." Shock (Augusta, Ga.), vol. 31, no. 2, 2009, pp. 139-45.
Chen YC, Jenq CC, Tian YC, et al. Rifle classification for predicting in-hospital mortality in critically ill sepsis patients. Shock. 2009;31(2):139-45.
Chen, Y. C., Jenq, C. C., Tian, Y. C., Chang, M. Y., Lin, C. Y., Chang, C. C., Lin, H. C., Fang, J. T., Yang, C. W., & Lin, S. M. (2009). Rifle classification for predicting in-hospital mortality in critically ill sepsis patients. Shock (Augusta, Ga.), 31(2), 139-45. https://doi.org/10.1097/SHK.0b013e31817d419e
Chen YC, et al. Rifle Classification for Predicting In-hospital Mortality in Critically Ill Sepsis Patients. Shock. 2009;31(2):139-45. PubMed PMID: 18520698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rifle classification for predicting in-hospital mortality in critically ill sepsis patients. AU - Chen,Yung-Chang, AU - Jenq,Chang-Chyi, AU - Tian,Ya-Chung, AU - Chang,Ming-Yang, AU - Lin,Chan-Yu, AU - Chang,Chih-Cheng, AU - Lin,Horng-Chyuan, AU - Fang,Ji-Tseng, AU - Yang,Chih-Wei, AU - Lin,Shu-Min, PY - 2008/6/4/pubmed PY - 2009/5/5/medline PY - 2008/6/4/entrez SP - 139 EP - 45 JF - Shock (Augusta, Ga.) JO - Shock VL - 31 IS - 2 N2 - Severe sepsis and septic shock, often complicated by acute kidney injury (AKI), are the most common causes of mortality in noncoronary intensive care units (ICUs). This study investigates the outcomes of critically ill patients with sepsis and elucidates the association between prognosis and risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage renal failure (RIFLE) classification. A total of 121 sepsis patients were admitted to ICU from June 2003 to January 2004. Forty-seven demographic, clinical, and laboratory variables were prospectively recorded for post hoc analysis as predictors of survival on the first day of ICU admission. Overall in-hospital mortality rate was 47.9%. Mortality was significantly associated (chi-square for trend; P < 0.001) with RIFLE classification. Septic shock, RIFLE category, and number of organ system failures on the first day of ICU admission were independent predictors of hospital mortality according to forward conditional logistic regression. The severity of RIFLE classification correlated with organ system failure number and Acute Physiology and Chronic Health Evaluation (APACHE) II to IV and sequential organ failure assessment scores. Cumulative survival rates at 6-month follow-up after hospital discharge significantly (P < 0.05) differed between non-AKI versus RIFLE injury, non-AKI versus RIFLE failure (RIFLE-F), and RIFLE risk versus RIFLE F. At 6-month follow-up, full recovery of renal function was noted in 85% of surviving patients with AKI (RIFLE risk, RIFLE injury, and RIFLE-F). In conclusion, these findings are consistent with a role for RIFLE classification in accurately predicting in-hospital mortality and short-term prognosis in ICU sepsis patients. SN - 1540-0514 UR - https://www.unboundmedicine.com/medline/citation/18520698/Rifle_classification_for_predicting_in_hospital_mortality_in_critically_ill_sepsis_patients_ L2 - https://doi.org/10.1097/SHK.0b013e31817d419e DB - PRIME DP - Unbound Medicine ER -