Risk factors for acute kidney injury and in-hospital mortality in patients receiving extracorporeal membrane oxygenation

Sung Woo Lee, Mi Yeon Yu, Hajeong Lee, Shin Young Ahn, Sejoong Kim, Ho Jun Chin, Ki Young Na

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background and Objectives Although acute kidney injury (AKI) is the most frequent complication in patients receiving extracorporeal membrane oxygenation (ECMO), few studies have been conducted on the risk factors of AKI.We performed this study to identify the risk factors of AKI associated with in-hospital mortality. Methods Data from 322 adult patients receiving ECMO were analyzed. AKI and its stages were defined according to Kidney Disease Improving Global Outcomes (KDIGO) classifications. Variables within 24 h before ECMO insertion were collected and analyzed for the associations with AKI and in-hospital mortality. Results Stage 3 AKI was associated with in-hospital mortality, with a hazard ratio (HR) (95% CI) of 2.690 (1.472-4.915) compared to non-AKI (p = 0.001). The simplified acute physiology score 2 (SAPS2) and serum sodium level were also associated with in-hospital mortality, with HRs of 1.02 (1.004-1.035) per 1 score increase (p = 0.01) and 1.042 (1.014-1.070) per 1 mmol/L increase (p = 0.003). The initial pump speed of ECMO was significantly related to in-hospital mortality with a HR of 1.333 (1.020-1.742) per 1,000 rpm increase (p = 0.04). The pump speed was also associated with AKI (p = 0.02) and stage 3 AKI (p = 0.03) with ORs (95% CI) of 2.018 (1.129-3.609) and 1.576 (1.058-2.348), respectively. We also found that the red cell distribution width (RDW) above 14.1%was significantly related to stage 3 AKI. Conclusion The initial pump speed of ECMO was a significant risk factor of in-hospital mortality and AKI in patients receiving ECMO. The RDW was a risk factor of stage 3 AKI.

Original languageEnglish
Article numbere0140674
JournalPLoS One
Volume10
Issue number10
DOIs
Publication statusPublished - 2015 Oct 15
Externally publishedYes

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Extracorporeal Membrane Oxygenation
Oxygenation
Hospital Mortality
Acute Kidney Injury
risk factors
kidneys
Membranes
Pumps
Hazards
pumps
Erythrocyte Indices
Physiology
Sodium
Cells
Kidney Diseases
kidney diseases
health status

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Risk factors for acute kidney injury and in-hospital mortality in patients receiving extracorporeal membrane oxygenation. / Lee, Sung Woo; Yu, Mi Yeon; Lee, Hajeong; Ahn, Shin Young; Kim, Sejoong; Chin, Ho Jun; Na, Ki Young.

In: PLoS One, Vol. 10, No. 10, e0140674, 15.10.2015.

Research output: Contribution to journalArticle

Lee, Sung Woo ; Yu, Mi Yeon ; Lee, Hajeong ; Ahn, Shin Young ; Kim, Sejoong ; Chin, Ho Jun ; Na, Ki Young. / Risk factors for acute kidney injury and in-hospital mortality in patients receiving extracorporeal membrane oxygenation. In: PLoS One. 2015 ; Vol. 10, No. 10.
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abstract = "Background and Objectives Although acute kidney injury (AKI) is the most frequent complication in patients receiving extracorporeal membrane oxygenation (ECMO), few studies have been conducted on the risk factors of AKI.We performed this study to identify the risk factors of AKI associated with in-hospital mortality. Methods Data from 322 adult patients receiving ECMO were analyzed. AKI and its stages were defined according to Kidney Disease Improving Global Outcomes (KDIGO) classifications. Variables within 24 h before ECMO insertion were collected and analyzed for the associations with AKI and in-hospital mortality. Results Stage 3 AKI was associated with in-hospital mortality, with a hazard ratio (HR) (95{\%} CI) of 2.690 (1.472-4.915) compared to non-AKI (p = 0.001). The simplified acute physiology score 2 (SAPS2) and serum sodium level were also associated with in-hospital mortality, with HRs of 1.02 (1.004-1.035) per 1 score increase (p = 0.01) and 1.042 (1.014-1.070) per 1 mmol/L increase (p = 0.003). The initial pump speed of ECMO was significantly related to in-hospital mortality with a HR of 1.333 (1.020-1.742) per 1,000 rpm increase (p = 0.04). The pump speed was also associated with AKI (p = 0.02) and stage 3 AKI (p = 0.03) with ORs (95{\%} CI) of 2.018 (1.129-3.609) and 1.576 (1.058-2.348), respectively. We also found that the red cell distribution width (RDW) above 14.1{\%}was significantly related to stage 3 AKI. Conclusion The initial pump speed of ECMO was a significant risk factor of in-hospital mortality and AKI in patients receiving ECMO. The RDW was a risk factor of stage 3 AKI.",
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AU - Chin, Ho Jun

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AB - Background and Objectives Although acute kidney injury (AKI) is the most frequent complication in patients receiving extracorporeal membrane oxygenation (ECMO), few studies have been conducted on the risk factors of AKI.We performed this study to identify the risk factors of AKI associated with in-hospital mortality. Methods Data from 322 adult patients receiving ECMO were analyzed. AKI and its stages were defined according to Kidney Disease Improving Global Outcomes (KDIGO) classifications. Variables within 24 h before ECMO insertion were collected and analyzed for the associations with AKI and in-hospital mortality. Results Stage 3 AKI was associated with in-hospital mortality, with a hazard ratio (HR) (95% CI) of 2.690 (1.472-4.915) compared to non-AKI (p = 0.001). The simplified acute physiology score 2 (SAPS2) and serum sodium level were also associated with in-hospital mortality, with HRs of 1.02 (1.004-1.035) per 1 score increase (p = 0.01) and 1.042 (1.014-1.070) per 1 mmol/L increase (p = 0.003). The initial pump speed of ECMO was significantly related to in-hospital mortality with a HR of 1.333 (1.020-1.742) per 1,000 rpm increase (p = 0.04). The pump speed was also associated with AKI (p = 0.02) and stage 3 AKI (p = 0.03) with ORs (95% CI) of 2.018 (1.129-3.609) and 1.576 (1.058-2.348), respectively. We also found that the red cell distribution width (RDW) above 14.1%was significantly related to stage 3 AKI. Conclusion The initial pump speed of ECMO was a significant risk factor of in-hospital mortality and AKI in patients receiving ECMO. The RDW was a risk factor of stage 3 AKI.

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