دورية أكاديمية
Accuracy of clinicians’ ability to predict the need for renal replacement therapy: a prospective multicenter study
| العنوان: | Accuracy of clinicians’ ability to predict the need for renal replacement therapy: a prospective multicenter study |
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| المؤلفون: | Sitbon, Alexandre, Darmon, Michaël, Geri, Guillaume, Jaubert, Paul, Lamouche-Wilquin, Pauline, Monet, Clément, Le Fèvre, Lucie, Baron, Marie, Harlay, Marie-Line, Bureau, Côme, Joannes-Boyau, Olivier, Dupuis, Claire, Contou, Damien, Lemiale, Virginie, Simon, Marie, Vinsonneau, Christophe, Blayau, Clarisse, Jacobs, Frederic, Zafrani, Lara |
| المساهمون: | Hopital Saint-Louis AP-HP (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU), Université Paris Cité (UPCité), Hôpital Ambroise Paré AP-HP, CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Service d'anesthésie et réanimation chirurgicale Nantes, Hôtel-Dieu-Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes), Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), CIC Hôpital Bichat, AP-HP - Hôpital Bichat - Claude Bernard Paris, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine, Centre Hospitalier Sud Francilien, Hôpital de Hautepierre Strasbourg, CHU Pitié-Salpêtrière AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Haut-Lévêque - CHU de Bordeaux (Centre médico chirurgical Magellan), CHU Gabriel Montpied Clermont-Ferrand, CHU Clermont-Ferrand, Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre hospitalier Argenteuil (CH Argenteuil), Hôpital Edouard Herriot CHU - HCL, Hospices Civils de Lyon (HCL), Centre Hospitalier de Béthune (CH Béthune), GHT de l'Artois, CHU Tenon AP-HP, AP-HP - Hôpital Antoine Béclère Clamart |
| المصدر: | ISSN: 2110-5820 ; Annals of Intensive Care ; https://hal.science/hal-04457716Test ; Annals of Intensive Care, 2022, 12 (1), pp.95. ⟨10.1186/s13613-022-01066-w⟩. |
| بيانات النشر: | HAL CCSD SpringerOpen |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Renal replacement therapy, Physician prediction, Acute kidney injury, Intensive care unit, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | International audience ; Purpose. Identifying patients who will receive renal replacement therapy (RRT) during intensive care unit (ICU) stay is a major challenge for intensivists. The objective of this study was to evaluate the performance of physicians in predicting the need for RRT at ICU admission and at acute kidney injury (AKI) diagnosis. Methods. Prospective, multicenter study including all adult patients hospitalized in 16 ICUs in October 2020. Physician prediction was estimated at ICU admission and at AKI diagnosis, according to a visual Likert scale. Discrimination, risk stratification and benefit of physician estimation were assessed. Mixed logistic regression models of variables associated with risk of receiving RRT, with and without physician estimation, were compared. Results. Six hundred and forty-nine patients were included, 270 (41.6%) developed AKI and 77 (11.8%) received RRT. At ICU admission and at AKI diagnosis, a model including physician prediction, the experience of the physician, SOFA score, serum creatinine and diuresis to determine need for RRT performed better than a model without physician estimation with an area under the ROC curve of 0.90 [95% CI 0.86–0.94, p < 0.008 (at ICU admission)] and 0.89 [95% CI 0.83–0.93, p = 0.0014 (at AKI diagnosis)]. In multivariate analysis, physician prediction was strongly associated with the need for RRT, independently of creatinine levels, diuresis, SOFA score and the experience of the doctor who made the prediction. Conclusion. As physicians are able to stratify patients at high risk of RRT, physician judgement should be taken into account when designing new randomized studies focusing on RRT initiation during AKI. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-04457716; https://hal.science/hal-04457716Test; https://hal.science/hal-04457716/documentTest; https://hal.science/hal-04457716/file/s13613-022-01066-w.pdfTest |
| DOI: | 10.1186/s13613-022-01066-w |
| الإتاحة: | https://doi.org/10.1186/s13613-022-01066-wTest https://hal.science/hal-04457716Test https://hal.science/hal-04457716/documentTest https://hal.science/hal-04457716/file/s13613-022-01066-w.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.64D423BD |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13613-022-01066-w |
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