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Critical Care
Published in: Critical Care 5/2013

Open Access 01-10-2013 | Research

Six-month survival and quality of life of intensive care patients with acute kidney injury

Authors: Sara Nisula, Suvi T Vaara, Kirsi-Maija Kaukonen, Matti Reinikainen, Simo-Pekka Koivisto, Outi Inkinen, Meri Poukkanen, Pekka Tiainen, Ville Pettilä, Anna-Maija Korhonen, the FINNAKI-QOL Study Group

Published in: Critical Care | Issue 5/2013

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Abstract

Introduction

Acute kidney injury (AKI) has high incidence among the critically ill and associates with dismal outcome. Not only the long-term survival, but also the quality of life (QOL) of patients with AKI is relevant due to substantial burden of care regarding these patients. We aimed to study the long-term outcome and QOL of patients with AKI treated in intensive care units.

Methods

We conducted a predefined six-month follow-up of adult intensive care unit (ICU) patients from the prospective, observational, multi-centre FINNAKI study. We evaluated the QOL of survivors with the EuroQol (EQ-5D) questionnaire. We included all participating sites with at least 70% rate of QOL measurements in the analysis.

Results

Of the 1,568 study patients, 635 (40.5%, 95% confidence interval (CI) 38.0-43.0%) had AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Of the 635 AKI patients, 224 (35.3%), as compared to 154/933 (16.5%) patients without AKI, died within six months. Of the 1,190 survivors, 959 (80.6%) answered the EQ-5D questionnaire at six months. The QOL (median with Interquartile range, IQR) measured with the EQ-5D index and compared to age- and sex-matched general population was: 0.676 (0.520-1.00) versus 0.826 (0.812-0.859) for AKI patients, and 0.690 (0.533-1.00) versus 0.845 (0.812-0.882) for patients without AKI (P <0.001 in both). The EQ-5D at the time of ICU admission was available for 774 (80.7%) of the six-month respondents. We detected a mean increase of 0.017 for non-AKI and of 0.024 for AKI patients in the EQ-5D index (P = 0.728). The EQ-5D visual analogue scores (median with IQR) of patients with AKI (70 (50–83)) and patients without AKI (75 (60–87)) were not different from the age- and sex-matched general population (69 (68–73) and 70 (68–77)).

Conclusions

The health-related quality of life of patients with and without AKI was already lower on ICU admission than that of the age- and sex-matched general population, and did not change significantly during critical illness. Patients with and without AKI rate their subjective health to be as good as age and sex-matched general population despite statistically significantly lower QOL indexes measured by EQ-5D.
Appendix
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Metadata
Title
Six-month survival and quality of life of intensive care patients with acute kidney injury
Authors
Sara Nisula
Suvi T Vaara
Kirsi-Maija Kaukonen
Matti Reinikainen
Simo-Pekka Koivisto
Outi Inkinen
Meri Poukkanen
Pekka Tiainen
Ville Pettilä
Anna-Maija Korhonen
the FINNAKI-QOL Study Group
Publication date
01-10-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 5/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc13076

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