ABSTRACT
Background: Acute kidney injury (AKI) is a common occurrence in intensive care units. Mortality is more for patients with AKI than those without AKI. KDIGO classification system is a recent tool to stage AKI. Outcomes of AKI depend on stage of the disease, underlying aetiologies and interventions. Objectives were to study the ability of KDIGO classification in predicting the outcomes of acute kidney injury in patients admitted to the intensive care units of a tertiary care centre, to predict the mortality among acute kidney injury patients admitted for intensive care and to study the clinical and etiological profile of acute kidney injury in such patients. Materials and methods: 153 subjects from Medical ICUs admitted with AKI were included. The period of study was from 1st January 2016 to 31st December 2016. After getting proper consent, details were taken in proforma. Patients coming under exclusion criteria were excluded. Data of 153 patients entered in excel sheet and with various statistical tools the data were analysed. Results: Globally subjects with AKI in ICU, the mortality is about 40 to 60%. Duration of ICU stay among Stage III patients were comparatively longer than those in stage II and stage I (p<0.05). Patients undergoing RRT hold higher mortality. AKI patients who need HD or PD as Renal replacement had comparatively higher rates of mortality than those doesn't require RRT (p<0.05). There was no significant association between age of the patients and mortality (P>0.05). There was no significant association between mortality and gender. Binary logistic regression model for mortality was performed to predict the independent risk factors of mortality. The regression analysis revealed Sreenath S, Santhosh Kumar T.S., Retheesh kumar. KDIGO Classification in Predicting the Outcomes of Acute Kidney Injury in Patients in Intensive Care Units of a Tertiary Care Centre. IAIM, 2018; 5(8): 30-40. Page 31 that staging according to KDIGO, sepsis, hypertension and diabetes has independent predictability in mortality. Conclusion: We concluded that higher the stage of AKI, the higher will be the mortality and also staging can predict mortality. So staging AKI patients with KDIGO classification holds statistical significance
ABSTRACT
Background: Stroke is a major health problem in India. Stroke burden has been rising in India as compared to the developed countries. Recent studies have shown that high serum cholesterol is associated with clinically less severe ischaemic strokes and better outcome. Aim: The primary objective of the study was to compare the outcome of patients with ischaemic stroke to their cholesterol levels and to correlate the cholesterol levels to the stroke outcome. Materials and methods: This hospital based prospective follow-up study was conducted in 140 patients admitted with ischaemic stroke in the medical wards of Medical College hospital, Trivandrum. Patients were divided into 2 groups based on cholesterol levels as <160 mg/dl and >160 mg/dl. Their clinical severity at presentation was calculated by Scandinavian stroke scale (0=worst, 58=best) and outcome of these patients at the end of 1 year was measured by Modified Rankin scale (0=best, 6=worst).Serum cholesterol was measured using enzymatic method. Results: Mean age of 140 patients of at presentation was 63.4±11.9 years of which 53.5% (n=75) males, the mean Scandinavian stroke scale (SSS) being 28.3±12.5. The mean SSS score of high cholesterol group was 39.6 whereas 17 in the low cholesterol group (p<0.001). Similarly, the size of infarct in CT brain, outcome variables of modified Rankin scale and mortality were statistically significant between these groups (p<0.001). Bivariate correlation analysis showed that increased serum cholesterol level is associated with increased SSS score (positive correlation) with high statistical significance (p<0.001). Logistic regression adjustedwith other risk factors showed high cholesterol levels are associated with better outcome and decreased mortality, which is supported by Kaplan-Meier survival analysis. Sreenath S, Santhosh Kumar T.S., Parthiban, Jasen Joseph, Ratheesh Kumar V.R. Study of cholesterol levels in patients with ischaemic stroke and their outcome. IAIM, 2017; 4(10): 194-202. Page 195 Conclusion: Hypercholesterolemia is associated with clinically minor strokes and better outcome, whereas major strokes are commonly seen in patients in the low cholesterol group. Hence post stroke outcome is inversely related to serum cholesterol levels in ischaemic stroke patients.