Critical Care

, 19:P297 | Cite as

Base deficit and SOFA score are predictive factors of early acute kidney injury in oncologic surgical patients

  • A Gerent
  • J Almeida
  • E Almeida
  • A Lousada
  • C Park
  • J Ribeiro
  • J Fukushima
  • A Leme
  • E Osawa
  • A Rezende
  • I Bispo
  • F Galas
  • L Hajjar
Open Access
Poster presentation
  • 240 Downloads

Keywords

Acute Kidney Injury Sequential Organ Failure Assessment Sequential Organ Failure Assessment Score Base Deficit Acute Kidney Injury Network 

Introduction

Patients who undergo major oncology surgery are under high risk to develop postoperative acute kidney injury (AKI), mainly due to inflammatory and ischemic insults. This complication results in worse outcomes. The aim of this study is to identify predictive factors of AKI in this population.

Methods

We performed an observational study in 285 consecutive patients admitted to a surgical ICU after major abdominal oncology surgery. Baseline characteristics, laboratorial, clinical and intraoperative data, such as type of fluids, blood transfusion, bleeding and use of vasopressor, were collected at ICU admission. Early acute kidney injury was defined according to the Acute Kidney Injury Network classification at 48 hours of ICU admission. Logistic regression model was performed using AKI as the outcome.

Results

There were 76 (26.7%) patients who developed AKI within the first 48 hours after ICU admission. In a univariate analysis, patients with AKI were more likely to be male, had higher Sequential Organ Failure Assessment (SOFA) score, higher baseline serum creatinine and urea levels, higher serum lactate levels and had more metabolic academia at admission. These patients also had a higher 24-hour Simplified Acute Physiology III score and higher length of mechanical ventilation as compared with non-AKI patients. There were no differences between patients regarding intraoperative vasopressors, type and amount of fluids, diuresis and blood transfusion. In a multivariate analysis we identified admission base deficit (BD) (OR = 1.13, 95% CI = 1.02 to 1.24, P = 0.017) and SOFA score (OR = 1.35, 95% CI = 1.2 to 1.51, P < 0.001) as independent predictive factors of early AKI.

Conclusion

Both SOFA score and BD may be used to predict AKI in surgical oncology patients at ICU admission. These variables allow physicians to recognize early patients who might be under risk, and anticipate measures to avoid further renal impairment.

References

  1. 1.
    Rocktaeschel J, Morimatsu H, Uchino S, Goldsmith D, Poustie S, Story D, et al: Acid-base status of critically ill patients with acute renal failure: analysis based on Stewart-Figge methodology. Crit Care. 2003, 7: R60-10.1186/cc2333.PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Smith I, Kumar P, Molloy S, Rhodes A, Newman PJ, Grounds RM, et al: Base excess and lactate as prognostic indicators for patients admitted to intensive care. Intensive Care Med. 2001, 74-83. 27CrossRefPubMedGoogle Scholar

Copyright information

© Gerent et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • A Gerent
    • 1
  • J Almeida
    • 1
  • E Almeida
    • 1
  • A Lousada
    • 1
  • C Park
    • 1
  • J Ribeiro
    • 1
  • J Fukushima
    • 1
  • A Leme
    • 1
  • E Osawa
    • 1
  • A Rezende
    • 1
  • I Bispo
    • 1
  • F Galas
    • 1
  • L Hajjar
    • 1
  1. 1.Instituto do Cancer do Estado de São Paulo - ICESPSão PauloBrazil

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