Evaluation of Acute Kidney Injury Defined by Rifle Criteria and its Association with Mortality in Critically Ill Obstetric Patients: A Retrospective Study
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- Category: Vol. 79, December 2011
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Evaluation of Acute Kidney Injury Defined by Rifle Criteria and its Association with Mortality in Critically Ill Obstetric Patients: A Retrospective Study,SOHA SIAM, AZZA A. ABD EL HAMEED and HEBA MATAR
Abstract
Objective: To assess the occurrence of AKI according to the RIFLE classification and its correlation with hospital mortality in Obstetric patients admitted to intensive care unit.
Design: Retrospective study.
Setting: Intensive Care Unit of Zagazig University Hos-pitals.
Population: All obstetric patients admitted to ICU from January 2007 to December 2010.
Methods: The RIFLE classification (Risk, Injury, Failure, loss and end stage) was applied to all cases of AKI at admission, patients were assigned to their worst RIFLE category according to either serum creatinine or urine output criteria.
Main Outcome Measures: Mortality from AKI, defined by RIFLE criteria.
Results: AKI occurred in 88 cases (12.39%) of obstetric patients admitted to ICU. The main causes of AKI were obstetric hemorrhage 34 (38.63%), pregnancy-related hyper-tension 25 (28.4%), HELLP syndrome 14 (15.9%), sepsis 6 (6.81%), anesthetic complications 4 (4.54%), pulmonary embolism 2 (2.27%) and acute fatty liver 3 (3.3%). Patients with AKI were classified according to the RIFLE criteria into Risk 32 (36.36%), Injury 33 (37.5%), Failure 11 (12.5%) and loss 12 (13.63%). The most common causes of death among cases with AKI were as follows; obstetric hemorrhage (35%), HELLP syndrome (27.5%), and PIH (20%). As regard RIFLE classification the category of injury is the highest among them.
Conclusion: The RIFLE classification system is a simple and applicable tool in predicting the risk of mortality from AKI in obstetric ICU patients. We advise its routine use in the evaluation of critically ill obstetric patients with AKI.