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Early mortality on continuous renal replacement therapy (CRRT): the prairie CRRT study

Overview of attention for article published in Canadian Journal of Kidney Health and Disease, July 2016
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Title
Early mortality on continuous renal replacement therapy (CRRT): the prairie CRRT study
Published in
Canadian Journal of Kidney Health and Disease, July 2016
DOI 10.1186/s40697-016-0124-7
Pubmed ID
Authors

Bhanu Prasad, Michelle Urbanski, Thomas W. Ferguson, Erwin Karreman, Nav Tangri

Abstract

Patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) have an increased short-term and long-term risk of mortality. In most North American intensive care units (ICUs), these patients receive continuous renal replacement therapy (CRRT). We aim to identify clinical and demographic factors associated with mortality within 24 h of initiating CRRT. This paper is a prospective cohort study. The setting involves three ICUs (12-bed surgical ICU, 10-bed medical ICU, and a 7-bed combined ICU for both medical and surgical patients) of the Regina Qu'Appelle Health Region (RQHR) Saskatchewan, Canada. The patients were 106 individuals with AKI who were admitted to the ICUs and received CRRT from April 2013 to September 2014. Date and time of admission, transfer to, and initiation of CRRT were documented. Demographic data, use of vasoactive medications, ventilator settings, pH, urine output, and chronic disease comorbidities were measured. The methods involved a stepwise multiple variable logistic regression model using death within 24 h of starting CRRT as the dependent variable, with significant variables derived from univariate analysis as covariates. Of the 2634 patients admitted to the ICUs in the study period (April 2013 to September 2014), 83.6 % (2201/2634) had no AKI. Two hundred and sixty-nine or 10.2 % of the patients had stage 3 AKI. One hundred six of the 269 patients (40%) were started on CRRT. Of those on CRRT, 66/106 died in the ICU while on CRRT. Seventeen of the 66 patients (26%) died within 24 h of initiating therapy. In univariate logistic regression models, factors associated with early mortality included fraction of inspired oxygen (per 0.1 unit) (OR 1.39, 95 % CI 1.09-1.77); epinephrine dose >10 μg/min (OR 5.81, 95 % CI 1.86-18.16); vasopressin >0.02 μg/min (OR 3.99, 95 % CI 1.07-14.84); and norepinephrine dose >20 μg/min (OR 11.04, 95 % CI 2.38-51.24) which were associated with early mortality. When included in stepwise multivariate logistic regression analysis, only FiO2 (per 0.1 unit) and the dose of norepinephrine of >20 μg/min were independently associated with early mortality. The small sample size was a limitation of this study. Patients admitted to the ICU with AKI requiring CRRT have a high risk of early mortality. In these patients, vasopressor use and hypoxia were independently associated with adverse short-term survival.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 36 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 17%
Other 4 11%
Researcher 4 11%
Librarian 3 8%
Professor > Associate Professor 3 8%
Other 7 19%
Unknown 9 25%
Readers by discipline Count As %
Medicine and Dentistry 17 47%
Nursing and Health Professions 4 11%
Psychology 2 6%
Agricultural and Biological Sciences 1 3%
Chemical Engineering 1 3%
Other 2 6%
Unknown 9 25%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 July 2016.
All research outputs
#14,388,554
of 25,374,647 outputs
Outputs from Canadian Journal of Kidney Health and Disease
#342
of 620 outputs
Outputs of similar age
#199,581
of 378,458 outputs
Outputs of similar age from Canadian Journal of Kidney Health and Disease
#6
of 7 outputs
Altmetric has tracked 25,374,647 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 620 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.6. This one is in the 43rd percentile – i.e., 43% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 378,458 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 7 others from the same source and published within six weeks on either side of this one.