CREAT Score Predicts Early Mortality in Elderly Patients With Acute Kidney Injury Undergoing Continuous Renal Replacement Therapy

Eric Chien-Hwa Wu ； Chieh-Li Yen ； Jia-Jin Chen ； George Kuo ； Chih-Chung Shiao ； Cheng-Chia Lee ； Kun-Hua Tu ； Yung-Chang Chen ； Ya-Chung Tian ； Chih-Hsiang Chang

《Acta Nephrologica》 35卷4期 (2021/12) Pp. 211-220

https://doi.org/10.6221/AN.202112_35(4).0006

摘要

BACKGROUND: Patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT), especially elderly individuals, have a high mortality rate. This study aimed to evaluate the associated risk factors and develop a risk-prediction model for early mortality in elderly patients with AKI undergoing CRRT. METHODS: Patients in their 80s with AKI admitted to the intensive care unit and receiving CRRT from 2007 to 2018 were included in the study. We analyzed the risk factors associated with mortality within 7 days of CRRT initiation to establish a clinical score. RESULTS: A total of 413 patients were selected for analysis; 236 patients (57.1%) died within 7 days after CRRT initiation. The risk-prediction model, namely CREAT (cardiac/heart failure, chronic renal disease, elevated hemoglobin, albumin level, and total bilirubin) score, was developed to predict the 7-day mortality rate after CRRT initiation, with a relevant score range of 3-19. A CREAT score ≥ 5 corresponds to a ≥ 50% mortality rate, whereas a score ≥ 19 predicts a ≥ 90% mortality rate. CONCLUSION: CREAT score is a novel and practical tool for assessing early mortality risk in patients with AKI undergoing CRRT and could help guide treatments of elderly patients.

關鍵字

acute kidney injury ； aged ； continuous renal replacement therapy ； mortality ； prediction model