Lack of a ＂Weekend Effect＂ for Patients with Dialysis-Requiring Acute Kidney Injury in Surgical Intensive Care Units

Kun-Mo Lin ； Pei-Chen Wu ； Cheng-Jui Lin ； Chih-Jen Wu ； Wen-Je Ko ； Vin-Cent Wu ； Chi-Feng Pan ； the NSARF Group

《Acta Nephrologica》 31卷2期 (2017/06) Pp. 67-75

https://doi.org/10.6221/AN.2017003

摘要

BACKGROUND: Literature is sparse concerning the interplay between the day of the week of renal replacement therapy (RRT) initiation and short-term mortality in surgical acute kidney injury (AKI) patients. The aim of our study was to explore the effect of day of the week on the AKI-mortality relationship. METHODS: This prospectively collected cohort investigated adult patients who underwent RRT in multicenter surgical intensive care units (SICUs) from January 1, 2001 to December 31, 2012. These patients were categorized into two groups: RRT initiation on the weekends and on the weekdays. Logistic regression models were used to analyze the factors predictive of intensive care unit (ICU) and hospital mortality. RESULTS: A total of 476 patients who initiated RRT on the weekends and 1565 initiating RRT on the weekdays were analyzed. The crude ICU and hospital mortality rates were similar between groups (43.5% vs. 42.4%, P = 0.71 and 48.7% vs. 49.1%, P = 0.92, respectively). In multivariate analysis, weekend initiation of RRT had no effect on the short-term outcome, and hospital size did not modify the association of weekend initiation with mortality. CONCLUSION: In terms of short-term mortality, the day of the week of RRT initiation did not affect the outcomes of AKI patients in the setting of SICU.

關鍵字

acute kidney injury ； intensive care units ； mortality ； renal replacement therapy