J LIN1, Y WANG1, 2*, R Bellomo1, ML DUAN3, MP Gallagher1,2*
1The George Institute for Global Health, Camperdown, Australia; 2The University of New South Wales; 3Beijing Friendship Hospital, Capital Medical University, China. *corresponding authors
Aim: To evaluate the prognostic value of SOFA coagulation scores in patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (RRT).
Background: A decline in platelet count is common in critically ill patients with severe AKI. However, there is relatively little data assessing the association of SOFA coagulation scores and clinical outcomes in severe AKI patients receiving continuous RRT.
Methods: We performed a secondary analysis from the Randomised Evaluation of Normal versus Augmented Level of RRT (RENAL) study. The primary endpoint was all-cause mortality at 90 days after randomisation. The secondary outcomes were the length of intensive care unit (ICU) and hospital stay. The association between the SOFA coagulation scores and these outcomes were analysed using multivariate Cox model adjusted for baseline variables.
Results: Among 1465 patients in the RENAL study, the complete SOFA coagulation score data were available in 1280 patients. Among them, 579 patients had high SOFA coagulation scores (defined as ≥1), while 701 patients had normal SOFA coagulation scores (<1). The univariate analysis showed that high SOFA coagulation scores were associated with higher mortality at day 90 (49% versus 38.5%, p=0.0002). There was no significant difference in the length of ICU and hospital stay between these two groups. In multivariate analysis, the association between high SOFA coagulation scores and increased mortality rate at 90 days remained significant.
Conclusions: In the RENAL study, an approximately 50% of patients had an increase in SOFA coagulation scores during their ICU admission. High SOFA coagulation scores were associated with increased mortality at 90 days.