Objective: To evaluate the organ system failures hospital mortality predictions in critically ill patients with acute renal failure requiring dialysis.
Design: Prospective, cohort study.
Setting: Intensive care units in a tertiary care university hospital in Taiwan.
Patients: A total of 112 patients admitted to the intensive care units with acute renal failure who required dialysis from January 1999 through December 1999.
Interventions: Collection of information necessary to compute the number of failed organs.
Measurements and results: Of the 112 patients studied, 75 were men and 37 were women. The mean age of survivors and non-survivors was 58.59 +/- 19.91 years and 58.76 +/- 19.62 years. The overall mortality rate was 67%. There were no significant differences between survivors and non-survivors in terms of age, gender, or indication for dialysis. The cause of death in the majority of patients was related to organ system failure during the 24 hours immediately preceding the initiation of acute hemodialysis, and carry mortality rates exceeding 83% with the coexistence of four or more failed organs. The area under the organ system failures prediction model receiver operating characteristic curve equaled 0.772 +/- 0.046.
Conclusion: We conclude that mortality rate for acute renal failure in intensive care unit patients continues to be high. Organ system failures prediction model performed well and simple in its ability to identify patients who die in hospital. Mortality rate increases as number of failed organ increases.