APACHE II AND ATN-ISS IN ACUTE RENAL FAILURE (ARF) IN INTENSIVE CARE UNIT (ICU) AND NON-ICU

APACHE II AND ATN-ISS IN ACUTE RENAL FAILURE (ARF) IN INTENSIVE CARE UNIT (ICU) AND NON-ICU INTRODUCTION. Acute renal failure (ARF) remains highly prevalent with a high rate of morbidity and mortality. OBJECTIVE. Of this study was to compare use of the APACHE II scoring prognosis with that of the ATN-ISS to determine whether the APACHE II could be used for patients with ARF outside the ICU. METHODS. For this purpose,, 205 patients with ARF were accompanied in a prospective cohort. Demographic data, preexisting conditions, organ failure and characteristics of ARF were analyzed. The prognostic scores were performed with the assessment of a nephrologist. RESULTS. The mean age was 52 +/- 18 years, 50% were male, 69% were white, 45% were treated in ICU and 55% in other units. Mortality in the ICU group was 85% and in the non-ICU group 18%. Factors that correlated with higher mortality were more prevalent in the ICU group: age, male, hospitalization with ARF organ failure, sepsis, septic IRA, oliguria and need of dialysis. Overall, the prognostic markers were the same for both the ICU and non-ICU groups. The discrimination with the APACHE II was similar in both, ICU and non-ICU groups and calibration was better in the non-ICU group. The ATN-ISS achieved good discrimination in both the ICU and non-ICU groups, but, regarding calibration, there was a discreet overestimating of mortality in the non-ICU group. The ATN-ISS showed a greater capacity for discrimination than the APACHE II in both the ICU and non-ICU groups. CONCLUSION. It was concluded that the APACHE II and ATN-ISS scores could be used for stratification of risk in patients with ARF treated outside of the ICU in Brazil. [Rev Assoc Med Bras 2009; 55(4): 434-41]