Urine Output and Mortality in Patients Resuscitated from out of Hospital Cardiac Arrest.
J Intensive Care Med
; 38(6): 544-552, 2023 Jun.
Artículo
en Inglés
| MEDLINE | ID: covidwho-2318949
ABSTRACT
BACKGROUND:
Limited data exist regarding urine output (UO) as a prognostic marker in out-of-hospital-cardiac-arrest (OHCA) survivors undergoing targeted temperature management (TTM).METHODS:
We included 247 comatose adult patients who underwent TTM after OHCA between 2007 and 2017, excluding patients with end-stage renal disease. Three groups were defined based on mean hourly UO during the first 24 h Group 1 (<0.5â mL/kg/h, n = 73), Group 2 (0.5-1â mL/kg/h, n = 81) and Group 3 (>1â mL/kg/h, n = 93). Serum creatinine was used to classify acute kidney injury (AKI). The primary and secondary outcomes respectively were in-hospital mortality and favorable neurological outcome at hospital discharge (modified Rankin Scale [mRS]<3).RESULTS:
In-hospital mortality decreased incrementally as UO increased (adjusted OR 0.9 per 0.1â mL/kg/h higher; p = 0.002). UO < 0.5â mL/kg/h was strongly associated with higher in-hospital mortality (adjusted OR 4.2 [1.6-10.8], p = 0.003) and less favorable neurological outcomes (adjusted OR 0.4 [0.2-0.8], p = 0.007). Even among patients without AKI, lower UO portended higher mortality (40% vs 15% vs 9% for UO groups 1, 2, and 3 respectively, p < 0.001).CONCLUSION:
Higher UO is incrementally associated with lower in-hospital mortality and better neurological outcomes. Oliguria may be a more sensitive early prognostic marker than creatinine-based AKI after OHCA.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Lesión Renal Aguda
/
Paro Cardíaco Extrahospitalario
/
Hipotermia Inducida
Tipo de estudio:
Estudio experimental
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
Tópicos:
Covid persistente
Límite:
Adulto
/
Humanos
Idioma:
Inglés
Revista:
J Intensive Care Med
Asunto de la revista:
Terapia intensiva
Año:
2023
Tipo del documento:
Artículo
País de afiliación:
08850666221151014
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