PURPOSE: Acute renal failure causes a high mortality rate in critically ill patients. We studied the accuracy of the APACHE IV scoring system to predict the development of renal failure requiring renal replacement therapy in critically ill patients.
METHODS: All patients admitted to the medical intensive care unit (MICU) between January 1, 2009 and April 1, 2009 had an APACHE IV score determined upon admission. Patients with renal failure requiring renal replacement therapy were identified. The Fischer’s exact test was used to determine correlation of the admission APACHE IV score and the development of renal failure.
RESULTS: 107 patients were admitted to the MICU during this period. Overall 25 patients (23%) had an APACHE IV score of 75 or greater. Eight (32%) patients with an APACHE IV score of 75 or greater developed renal failure as compared to 9 of 82 (11%) of patients with APACHE IV scores of less than 75 (P=0.024). Analysis of 61 patients with sepsis on admission revealed that 18 (30%) had an APACHE IV score greater than 75 with 7 (39%) developing renal failure versus 4 of 43 (9%) of patients that had and APACHE IV score greater than 75. 36 developed renal failure while no patients with an APACHE IV score less than 75 developed renal failure (P=0.026).
CONCLUSION: A high APACHE IV score of greater than 75 is associated with a higher rate of renal failure requiring renal replacement therapy.
CLINICAL IMPLICATIONS: The APACHE IV score on admission can be used to predict patients at high risk of developing renal failure.
DISCLOSURE: Robbert Crusio, No Financial Disclosure Information; No Product/Research Disclosure Information