Evidence map›Paper›PMID 32000715›Full record

ArticleBMC nephrology2020

Incidence, predictors and prognosis of acute kidney injury in nonagenarians: an in-hospital cohort study.

Andre Luis Bastos Sousa, Leticia Mascarenhas de Souza, Osvaldino Vieira Santana Filho, Victor Hugo Ferreira E Léda, Paulo Novis Rocha

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.0field-weighted citation impact, top 26% 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

10 citing papers in PubMed, 14 citations in OpenAlex.

  1. Observational
  2. Observational
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  5. Article
  6. A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023
    Article
  7. Impact of Diabetes on the Recurrence and Prognosis of Acute Kidney Injury in Older Male Patients: A 10-Year Retrospective Cohort Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022
    Article
  8. [Prognosis of in hospital nonagenarians with acute kidney injury].Anales del sistema sanitario de Navarra · 2021
    Article
  9. Article
  10. 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

5 authors at 1 institution in 1 country.

Andre Luis Bastos SousaMedical School of Bahia of the Federal University of Bahia, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA, 40110-100, Brazil. alb_sousa@yahoo.com.br.ORCID 0000-0002-7833-9106
Leticia Mascarenhas de SouzaMedical School of Bahia of the Federal University of Bahia, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA, 40110-100, Brazil.
Osvaldino Vieira Santana FilhoMedical School of Bahia of the Federal University of Bahia, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA, 40110-100, Brazil.
Victor Hugo Ferreira E LédaMedical School of Bahia of the Federal University of Bahia, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA, 40110-100, Brazil.
Paulo Novis RochaMedical School of Bahia of the Federal University of Bahia, Av. Reitor Miguel Calmon, S/N, Vale do Canela, Salvador, BA, 40110-100, Brazil.
Universidade Federal da Bahia · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGiven the aging of the population, nephrologists are ever more frequently assisting nonagenarians with acute kidney injury (AKI). The management of these patients presents unique characteristics, including bioethical dilemmas, such as the utilization of renal replacement therapy (RRT) at this extreme age.

methodsWe conducted a retrospective cohort study at a tertiary hospital. Over a 10-year period, 832 nonagenarians were hospitalized for two or more days. A random sample of 461 patients was obtained; 25 subjects were excluded due to lack of essential data. AKI was defined and staged according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria.

resultsWe analyzed data from 436 patients, mean age 93.5 ± 3.3 years, 74.3% female; 76.4% required intensive care unit (ICU). The incidence of AKI was 45%. Length of hospital stay, ICU admission, vasopressors, and mechanical ventilation (MV) were independent predictors of AKI. Overall in-hospital mortality was 43.1%. Mortality was higher in the AKI compared to the no AKI group (66.8% vs. 23.8%, p < 0.001). Only 13 patients underwent RRT; all were critically ill, requiring vasopressors and 76.9% in MV. Mortality for this RRT group was 100% but not significantly higher than that observed in 26 non-RRT controls (96.1%, p = 1.0) obtained by proportional random sampling, matched by variables related to illness severity. In multivariable analysis, age, Charlson's score, vasopressors, MV, and AKI - but not RRT - were independent predictors of mortality.

conclusionsAKI is common in hospitalized nonagenarians and carries a grave prognosis, especially in those who are critically iil. The use of RRT was not able to change the fatal prognosis of this subgroup of patients. Our data may help guide informed decisions about the utility of RRT in this scenario.

Indexed as

Hospital MortalityAcute Kidney InjuryAged, 80 and overCritical CareFemaleHumansIncidenceInpatientsLength of StayMalePrognosisRenal DialysisRespiration, ArtificialRetrospective StudiesRisk FactorsROC CurveVasoconstrictor AgentsAcute kidney injuryHemodialysisMortalityNonagenarians

Identifiers

PMID32000715
PMCPMC6993395
OpenAlexW3008227328

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.