Six-month survival and quality of life of intensive care patients with acute kidney injury.

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Six-month survival and quality of life of intensive care patients with acute kidney injury.

Crit Care. 2013 Oct 22;17(5):R250

Authors: Nisula S, Vaara ST, Kaukonen KM, Reinikainen M, Koivisto SP, Inkinen O, Poukkanen M, Tiainen P, Pettilä V, Korhonen AM

INTRODUCTION: Acute kidney injury (AKI) has high incidence among the critically ill and associates with dismal outcome. Not only the long-term survival, but also the quality of life (QOL) of patients with AKI is relevant due to substantial burden of care regarding these patients. We aimed to study the long-term outcome and QOL of patients with AKI treated in intensive care units.
METHODS: We conducted a predefined six-month follow-up of adult intensive care unit (ICU) patients from the prospective, observational, multi-centre FINNAKI study. We evaluated the QOL of survivors with the EuroQol (EQ-5D) questionnaire. We included all participating sites with at least 70% rate of QOL measurements in the analysis.
RESULTS: Of the 1568 study patients, 635 [40.5%, 95% confidence interval (CI) 38.0-43.0%] had AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Of the 635 AKI patients, 224 (35.3%), as compared to 154/933 (16.5%) patients without AKI, died within six months. Of the 1190 survivors, 959 (80.6%) answered the EQ-5D questionnaire at six months. The QOL (median with IQR) measured with the EQ-5D index and compared to age- and sex-matched general population was: 0.676 (0.520-1.00) vs. 0.826 (0.812-0.859) for AKI patients, and 0.690 (0.533-1.00) vs. 0.845 (0.812-0.882) for patients without AKI (P < 0.001 in both). The EQ-5D at the time of ICU admission was available for 774 (80.7%) of the six-month respondents. We detected a mean increase of 0.017 for non-AKI and of 0.024 for AKI patients in the EQ-5D index (P = 0.728). The EQ-5D visual analogue scores (median with IQR) of patients with AKI [70 (50--83)] and patients without AKI [75 (60--87)] were not different from the age- and sex-matched general population [69 (68--73) and 70 (68--77)].
CONCLUSIONS: The health-related quality of life of patients with and without AKI was already lower on ICU admission than that of the age- and sex-matched general population, and did not change significantly during critical illness. Patients with and without AKI rate their subjective health to be as good as age and sex-matched general population despite statistically significantly lower QOL indexes measured by EQ-5D.

PMID: 24148658 [PubMed - as supplied by publisher]

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