Survival and quality of life of patients requiring acute renal replacement therapy
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To assess long-term survival and health-related quality of life in patients with acute renal failure.
Design and setting
Cross-sectional cohort study in the ten-bed medical-surgical intensive care unit and the three-bed acute dialysis unit in a tertiary care hospital.
703 patients receiving renal replacement therapy for acute renal failure during 1998–2002.
Measurements and results
The mortality rate was 41% at 28 days, 57% at 1 year, and 70% at 5 years. SOFA score, age, and continuous renal replacement therapy were independent predictors of 1-year mortality. The median follow-up time was 3.9 years for mortality and 2.4 years for health-related quality of life. Of the 229 survivors in 2003, 153 (67%) responded to the health-related quality of life questionnaire. Health-related quality of life was evaluated with the EuroQol (EQ-5D) instrument including a visual analogue scale (VAS) score to evaluate the patient’s perceived health. The EQ-5D score was significantly lower in the study population than in the age- and gender-matched Finnish population (0.68 vs. 0.86). Median VAS scores were 69.5 and 70.0, respectively. Patients’ age and duration of follow-up had no significant effect on EQ-5D or VAS scores. Mortality and EQ-5D data were used to calculate quality-adjusted life years. Quality-adjusted survival was poor (15 quality-adjusted life years per 100 patients in the first year of follow-up).
The long-term survival of patients with acute renal failure is poor. Although survivors have a low health-related quality of life, they are as satisfied with their health as the general population.
KeywordsHealth-related quality of life Outcome Acute renal failure Intensive care Critical illness Mortality
We thank prof. Seppo Sarna for his help in the statistical analysis. The work was performed in the Intensive Care Unit of Meilahti Hospital, Helsinki University Central Hospital, which provided support for the research. This study was presented at the 34th Critical Care Congress of the Society of Critical Care Medicine in 2005 and published as an abstract in Critical Care Medicine.
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