Evidence map›Paper›PMID 31465554›Full record

Observational studyActa anaesthesiologica Scandinavica2020

Clinical examination findings as predictors of acute kidney injury in critically ill patients.

Renske Wiersema, Jacqueline Koeze, Ruben J Eck, Thomas Kaufmann, Bart Hiemstra, Geert Koster, Casper F M Franssen, Suvi T Vaara, Frederik Keus, Iwan C C Van der Horst

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta anaesthesiologica Scandinavica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Observational
  5. Observational
  6. Observational
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Renske WiersemaDepartment of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0003-2413-2852
Jacqueline KoezeDepartment of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0002-4660-3400
Ruben J EckDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0001-7440-2465
Thomas KaufmannDepartment of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0003-0589-8879
Bart HiemstraDepartment of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0001-6547-2138
Geert KosterDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0002-8927-3077
Casper F M FranssenDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0003-1004-9994
Suvi T VaaraDivision of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-6851-3828
Frederik KeusDepartment of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0003-1516-1475
Iwan C C Van der HorstDepartment of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0003-3891-8522
University Medical Center Groningen · NLUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute Kidney Injury (AKI) in critically ill patients is associated with a markedly increased morbidity and mortality. The aim of this study was to establish the predictive value of clinical examination for AKI in critically ill patients.

methodsThis was a sub-study of the SICS-I, a prospective observational cohort study of critically ill patients acutely admitted to the Intensive Care Unit (ICU). Clinical examination was performed within 24 hours of ICU admission. The occurrence of AKI was determined at day two and three after admission according to the KDIGO definition including serum creatinine and urine output. Multivariable regression modeling was used to assess the value of clinical examination for predicting AKI, adjusted for age, comorbidities and the use of vasopressors.

resultsA total of 1003 of 1075 SICS-I patients (93%) were included in this sub-study. 414 of 1003 patients (41%) fulfilled the criteria for AKI. Increased heart rate (OR 1.12 per 10 beats per minute increase, 98.5% CI 1.04-1.22), subjectively cold extremities (OR 1.52, 98.5% CI 1.07-2.16) and a prolonged capillary refill time on the sternum (OR 1.89, 98.5% CI 1.01-3.55) were associated with AKI. This multivariable analysis yielded an area under the receiver-operating curve (AUROC) of 0.70 (98.5% CI 0.66-0.74). The model performed better when lactate was included (AUROC of 0.72, 95%CI 0.69-0.75), P = .04.

conclusionClinical examination findings were able to predict AKI with moderate accuracy in a large cohort of critically ill patients. Findings of clinical examination on ICU admission may trigger further efforts to help predict developing AKI.

Indexed as

Acute Kidney InjuryCohort StudiesCreatinineCritical IllnessFemaleHumansMaleMiddle AgedProspective StudiesCreatinineacute kidney injurycapillary refill timeclinical examinationcritically illperipheral perfusion

Identifiers

PMID31465554
PMCPMC6916375
OpenAlexW2969999550

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.