Prognostic Factors of 30-Day In-Hospital Mortality in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.
Hyeon-Ju Lee, Taehee Kim, Heeyoung Lee and 3 others
PMID 41805682WHAT IT FOUND
Among 613 ICU patients on continuous renal replacement therapy, 52.1% died in hospital within 30 days.
Liver failure, worse organ failure, higher sodium, and lower consciousness were linked to death.
Key findings
01In the final sample of 613 patients, 30-day in-hospital mortality was 52.1% (n = 313).
02After adjustment, comorbid hepatic failure (adjusted HR 2.75), post-CRRT GCS (adjusted HR 0.82), post-CRRT SOFA (adjusted HR 1.16), and post-CRRT sodium (adjusted HR 1.05) were significantly associated with 30-day mortality risk.
03Pre- and intra-CRRT characteristics were not found to relate significantly to 30-day in-hospital mortality risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was retrospective and used only electronic medical records from one tertiary hospital, so missing or inconsistent documentation may have affected the variables. The authors said the final 613-patient sample was somewhat insufficient for the planned analysis, because they had calculated a minimum of 620 patients. Patients who died within the first 24 hours of CRRT were excluded, which may bias the sample toward patients who survived early CRRT. The study did not include the reasons for starting CRRT or nutritional support such as tube feeding, so those factors could have influenced mortality. Because it was observational, it can show associations after CRRT started but cannot prove that hepatic failure, GCS, SOFA, or sodium caused death or that correcting them would reduce mortality.
The easy way to misread this
Do not conclude that treating hepatic failure, improving GCS, lowering SOFA, or changing sodium during CRRT will reduce mortality. This retrospective record study only found associations with 30-day in-hospital death and did not test any treatment.