dc.contributor.author	Bagshaw, Sean M
dc.contributor.author	Sood, Manish M
dc.contributor.author	Long, Jennifer
dc.contributor.author	Fowler, Robert A
dc.contributor.author	Adhikari, Neill KJ
dc.contributor.author	Canadian Critical Care Trials Group H1N1 Collaborative
dc.date.accessioned	2013-06-26T23:03:32Z
dc.date.available	2013-06-26T23:03:32Z
dc.date.issued	2013-06-13
dc.date.updated	2013-06-26T23:03:32Z
dc.description.abstract	Abstract Background Canada’s pandemic H1N1 influenza A (pH1N1) outbreak led to a high burden of critical illness. Our objective was to describe the incidence of AKI (acute kidney injury) in these patients and risk factors for AKI, renal replacement therapy (RRT), and mortality. Methods From a prospective cohort of critically ill adults with confirmed or probable pH1N1 (16 April 2009–12 April 2010), we abstracted data on demographics, co-morbidities, acute physiology, AKI (defined by RIFLE criteria for Injury or Failure), treatments in the intensive care unit, and clinical outcomes. Univariable and multivariable logistic regression analyses were used to evaluate the associations between clinical characteristics and the outcomes of AKI, RRT, and hospital mortality. Results We included 562 patients with pH1N1-related critical illness (479 [85.2%] confirmed, 83 [14.8%] probable]: mean age 48.0 years, 53.4% female, and 13.3% aboriginal. Common co-morbidities included obesity, diabetes, and chronic obstructive pulmonary disease. AKI occurred in 60.9%, with RIFLE categories of Injury (23.0%) and Failure (37.9%). Independent predictors of AKI included obesity (OR 2.94; 95%CI, 1.75-4.91), chronic kidney disease (OR 4.50; 95%CI, 1.46-13.82), APACHE II score (OR per 1-unit increase 1.06; 95%CI, 1.03-1.09), and PaO2/FiO2 ratio (OR per 10-unit increase 0.98; 95%CI, 0.95-1.00). Of patients with AKI, 24.9% (85/342) received RRT and 25.8% (85/329) died. Independent predictors of RRT were obesity (OR 2.25; 95% CI, 1.14-4.44), day 1 mechanical ventilation (OR 4.09; 95% CI, 1.21-13.84), APACHE II score (OR per 1-unit increase 1.07; 95% CI, 1.03-1.12), and day 1 creatinine (OR per 10 μmol/L increase, 1.06; 95%CI, 1.03-1.10). Development of AKI was not independently associated with hospital mortality. Conclusion The incidence of AKI and RRT utilization were high among Canadian patients with critical illness due to pH1N1.
dc.description.version	Peer Reviewed
dc.identifier.citation	BMC Nephrology. 2013 Jun 13;14(1):123
dc.identifier.doi	http://dx.doi.org/10.1186/1471-2369-14-123
dc.identifier.uri	http://hdl.handle.net/1993/21686
dc.language.rfc3066	en
dc.rights	open access	en_US
dc.rights.holder	Sean M Bagshaw et al.; licensee BioMed Central Ltd.
dc.title	Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study
dc.type	Journal Article

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

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