Journal of Nephrology

, Volume 27, Issue 1, pp 65–71 | Cite as

Urine output on ICU entry is associated with hospital mortality in unselected critically ill patients

  • Zhongheng Zhang
  • Xiao Xu
  • Hongying Ni
  • Hongsheng Deng
Original Article

Abstract

Background and objective

Urine output (UO) is routinely measured in the intensive care unit (ICU) but its prognostic value remains debated. The study aimed to investigate the association between day 1 UO and hospital mortality.

Methods

Clinical data were abstracted from the Multiparameter Intelligent Monitoring in Intensive Care II (version 2.6) database. UO was recorded for the first 24 h after ICU entry, and was classified into three categories: UO >0.5, 0.3–0.5 and ≤0.3 ml/kg per hour. The primary endpoint was the hospital mortality. Four models were built to adjust for the hazards ratio of mortality.

Results

A total of 21,207 unselected ICU patients including 2,401 non-survivors and 18,806 survivors were included (mortality rate 11.3 %). Mortality rate increased progressively across UO categories: >0.5 (7.67 %), 0.3–0.5 (11.27 %) and ≤0.3 ml/kg/h (18.29 %), and this relationship remained statistically significant after rigorous control of confounding factors with the Cox proportional hazards regression model. With UO >0.5 as the referent group, the hazards ratios for UO 0.3–0.5 and UO ≤0.3 were 1.41 (95 % CI 1.29–1.54) and 1.52 (95 % CI 1.38–1.67), respectively.

Conclusion

UO obtained on ICU entry is an independent predictor of mortality irrespective of diuretic use. It would be interesting to examine whether strategies to increase UO would improve clinical outcome.

Keywords

Urine output Intensive care unit Hospital mortality Acute kidney injury 

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Copyright information

© Italian Society of Nephrology 2014

Authors and Affiliations

  • Zhongheng Zhang
    • 1
  • Xiao Xu
    • 1
  • Hongying Ni
    • 1
  • Hongsheng Deng
    • 1
  1. 1.Department of Critical Care Medicine, Jinhua Municipal Central HospitalJinhua Hospital of Zhejiang UniversityJinhuaPeople’s Republic of China

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