Evidence map›Paper›PMID 33740897›Full record

Observational studyBMC nephrology2021

Epidemiology and outcomes of elderly patients requiring renal replacement therapy in the intensive care unit: an observational study.

Cécile Salathé, Elettra Poli, Marco Altarelli, Nathan Axel Bianchi, Antoine Guillaume Schneider

Abstract readObservational Study
In one paragraph

Observational study in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Survive or thrive after ICU: what's the score?Annals of intensive care · 2023
    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.

Cécile SalathéAdult Intensive Care Unit, Service de Médecine Intensive Adulte, Centre Hospitalier Universitaire Vaudois (CHUV), 46, Avenue du Bugnon, 1011, Lausanne, Switzerland.
Elettra PoliAdult Intensive Care Unit, Service de Médecine Intensive Adulte, Centre Hospitalier Universitaire Vaudois (CHUV), 46, Avenue du Bugnon, 1011, Lausanne, Switzerland.
Marco AltarelliAdult Intensive Care Unit, Service de Médecine Intensive Adulte, Centre Hospitalier Universitaire Vaudois (CHUV), 46, Avenue du Bugnon, 1011, Lausanne, Switzerland.
Nathan Axel BianchiAdult Intensive Care Unit, Service de Médecine Intensive Adulte, Centre Hospitalier Universitaire Vaudois (CHUV), 46, Avenue du Bugnon, 1011, Lausanne, Switzerland.
Antoine Guillaume SchneiderAdult Intensive Care Unit, Service de Médecine Intensive Adulte, Centre Hospitalier Universitaire Vaudois (CHUV), 46, Avenue du Bugnon, 1011, Lausanne, Switzerland. antoine.schneider@chuv.ch.ORCID 0000-0003-0576-7094

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRenal replacement therapy (RRT) in critically ill patients is associated with high morbidity and mortality. The appropriateness of RRT initiation is sometimes questioned in elderly patients. Therefore, we sought to evaluate the long-term mortality, dialysis dependence and quality of life (QOL) of elderly patients who survived critical illness requiring RRT.

methodsThis is a monocentric observational study including all patients > 55 yo who received RRT for acute kidney injury in our intensive care unit (ICU) between January 2015 and April 2018. At the time of the study (May 2019), we assessed if they were still alive by cross referencing our hospital database and the Swiss national death registry. We sent survivors written information and, subsequently, contacted them over the phone. We obtained their consent for participation, asked about their dialytic status and performed an EQ-5D survey with visual analog scale (VAS). Results were stratified according to their age at the time of ICU admission (G1: "55-65 yo"; G2: "> 65-75 yo" and G3: "> 75 yo"). QOL in G3 patients were compared to G1 and G2 and to predicted values.

resultsAmong the 352 eligible patients, 171 died during the index hospital admission. After a median follow-up time of 32.7 months (IQR 19.8), a further 62 had died (median time to death for ICU survivors 5.0 (IQR 15.0) months. Hence, 119 (33.6%) patients were still alive at the time of the study. We successfully contacted 96 (80.7%) of them and 83 (69.7%) were included in the study (G1: 24, G2: 44 and G3: 15). Only 6 (7.2%) were RRT dependent. Patients in G3 had lower EQ-5D and VAS scores than those in G1 and G2 (p < 0.01). These scores were also significantly lower than predicted values (p < 0.05).

conclusionsRRT patients have a very high in-hospital and post discharge mortality. Among survivors, RRT dependency was low. Irrespective of baseline values, patients > 75 yo who survived ICU had a lower QOL than younger patients. It was lower than predicted according to age and sex. The appropriateness of RRT initiation in elderly patients should be discussed according to their pre-existing QOL and frailty.

Indexed as

Intensive Care UnitsQuality of LifeRenal DialysisAcute Kidney InjuryAgedAged, 80 and overFemaleHumansMaleMiddle AgedTreatment OutcomeAcute kidney injury (AKI)ElderlyMortalityQuality of life (QOL)Renal replacement therapy (RRT)

Identifiers

PMID33740897
PMCPMC7980322

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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.