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array:24 [ "pii" => "S2341192918300751" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.02.012" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "915" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:314-22" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0034935618300501" "issn" => "00349356" "doi" => "10.1016/j.redar.2018.02.002" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "915" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Anestesiol Reanim. 2018;65:314-22" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 104 "formatos" => array:2 [ "HTML" => 82 "PDF" => 22 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Morbimortalidad del fracaso renal agudo en la Unidad de Cuidados Críticos de un hospital comarcal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "314" "paginaFinal" => "322" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Morbidity and mortality of acute renal failure in the Critical Care Unit of a regional hospital" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1140 "Ancho" => 1511 "Tamanyo" => 93501 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Estadios FRA-KDIGO (fórmula CKD-EPI a partir de la creatinina basal).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.E. Esteban Ciriano, J.M. Peña Porta, C. Vicente de Vera Floristán, S. Olagorta García, R. Álvarez Lipe, J.M. Vicente de Vera Floristán" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M.E." "apellidos" => "Esteban Ciriano" ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Peña Porta" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Vicente de Vera Floristán" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Olagorta García" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Álvarez Lipe" ] 5 => array:2 [ "nombre" => "J.M." "apellidos" => "Vicente de Vera Floristán" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192918300751" "doi" => "10.1016/j.redare.2018.02.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192918300751?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935618300501?idApp=UINPBA00004N" "url" => "/00349356/0000006500000006/v1_201805300407/S0034935618300501/v1_201805300407/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192918300763" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.02.013" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "917" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:323-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Whole-body computed tomography as a factor associated with lower mortality in severe geriatric trauma with thoracic-abdominal-pelvic injury" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "323" "paginaFinal" => "328" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La tomografía computarizada corporal como factor asociado a menor mortalidad en el traumatismo geriátrico grave con afectación toracoabdominopélvica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Y. Peñasco, M.J. Sánchez-Arguiano, A. González-Castro, J.C. Rodríguez-Borregán, R. Jáuregui, P. Escudero, M. Ortiz-Lasa" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Y." "apellidos" => "Peñasco" ] 1 => array:2 [ "nombre" => "M.J." "apellidos" => "Sánchez-Arguiano" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "González-Castro" ] 3 => array:2 [ "nombre" => "J.C." "apellidos" => "Rodríguez-Borregán" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Jáuregui" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Escudero" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Ortiz-Lasa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935618300525" "doi" => "10.1016/j.redar.2018.02.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935618300525?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192918300763?idApp=UINPBA00004N" "url" => "/23411929/0000006500000006/v1_201806130410/S2341192918300763/v1_201806130410/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341192918300817" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.01.019" "estado" => "S300" "fechaPublicacion" => "2018-06-01" "aid" => "911" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2018;65:306-13" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Outpatient intravenous multimodal elastomeric pump with methadone in ambulatory surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "306" "paginaFinal" => "313" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Analgesia multimodal domiciliaria con metadona en perfusión intravenosa mediante bomba elastomérica en cirugía mayor ambulatoria" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2405 "Ancho" => 1583 "Tamanyo" => 127281 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Box-plot showing VAS scores at 24 and 48<span class="elsevierStyleHsp" style=""></span>h in the different surgical groups analysed. Variables were measured at rest and on movement.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Gómez-López, X. Sala-Blanch, P.L. Gambús Cerrillo, A. López Gutiérrez, M. Agustí Lasús, M.T. Anglada Casas" "autores" => array:6 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Gómez-López" ] 1 => array:2 [ "nombre" => "X." "apellidos" => "Sala-Blanch" ] 2 => array:2 [ "nombre" => "P.L." "apellidos" => "Gambús Cerrillo" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "López Gutiérrez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Agustí Lasús" ] 5 => array:2 [ "nombre" => "M.T." "apellidos" => "Anglada Casas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S003493561830015X" "doi" => "10.1016/j.redar.2018.01.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493561830015X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192918300817?idApp=UINPBA00004N" "url" => "/23411929/0000006500000006/v1_201806130410/S2341192918300817/v1_201806130410/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Morbidity and mortality of acute renal failure in the Critical Care Unit of a regional hospital" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "314" "paginaFinal" => "322" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.E. Esteban Ciriano, J.M. Peña Porta, C. Vicente de Vera Floristán, S. Olagorta García, R. Álvarez Lipe, J.M. Vicente de Vera Floristán" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M.E." "apellidos" => "Esteban Ciriano" "email" => array:1 [ 0 => "pebares@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J.M." "apellidos" => "Peña Porta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Vicente de Vera Floristán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "S." "apellidos" => "Olagorta García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "R." "apellidos" => "Álvarez Lipe" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "J.M." "apellidos" => "Vicente de Vera Floristán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Anestesia, Hospital Reina Sofía, Tudela, Navarra, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Aragón, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Aragón, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Anestesia, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Aragón, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Morbimortalidad del fracaso renal agudo en la Unidad de Cuidados Críticos de un hospital comarcal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 839 "Ancho" => 1642 "Tamanyo" => 61658 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Percentage of deaths according to AKI-KDIGO at end of follow-up (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001; no AKI vs AKI).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The local hospital where this study was performed has a catchment population of 150,000. At the time of the study, the hospital had a Critical Care Unit (CCU) overseen by anaesthesiologists, where both medical and surgical critically ill patients are admitted. Patients who require diagnostic techniques or specialists that are unavailable in our hospital are admitted to the CCU and stabilised before being transferred to the reference centre.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The CCU is the hospital's Intensive Care Unit (ICU). It has 5 fully equipped single-bed cubicles where patients receive medical and nursing care. Although it has both basic and advanced monitoring devices, it cannot perform renal replacement. Patients needing this therapy are treated in the CCU by the hospital's Haemodialysis Unit.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Registry of all epidemiological and biostatistical data is compulsory in the CCU. Our autonomous community uses electronic health records both in hospitals and in primary care. This computer-based system allowed us to collect data from patients after hospital discharge, even when transferred to other centres.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In view of our access to such records, we decided to study the clinical and epidemiological profile of critical patients admitted to our CCU. We determined the epidemiological profile and survival prognosis of the patients in our series using the Charlson Comorbidity Index (CCI). The CCI has been widely used in different multivariable prognostic models, and its consistency and validity have been confirmed in numerous studies.<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Another reason for undertaking this study is the apparent absence of studies describing the management of acute kidney injury (AKI) in CCUs such as ours, despite an abundance of reports on AKI in the ICU setting.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The documented incidence of AKI is increasing rapidly. This may be due, in part, to an increased awareness of this pathology among clinicians, a greater degree of diagnostic consensus, and the development of widely used classification scales. Much effort has been invested in recent years in agreeing on a universal definition and classification system for AKI.<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">3–5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In a patient with elevated blood nitrogen products, it can be difficult to distinguish between chronic or acute kidney failure in the absence of previous kidney function tests. If these data are not available, diagnosis will rely on the patient history of symptoms.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In 2012, the Kidney Disease Improving Global Outcomes (KDIGO) published its definition of AKI – a synthesis of the 2 existing AKI classification systems, namely, the Risk, Injury, Failure, Loss of Kidney Function, and End-stage Kidney Disease (RIFLE) system, published in 2004, and the Acute Kidney Injury Network (AKIN) system, published in 2007. Several studies have shown that KDIGO can accurately identify acute kidney injury in critically ill patients with a high risk of mortality<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">7</span></a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The scales developed for the diagnosis of specific diseases are now considered the best tools for estimating prognosis. In the case of AKI, we have the KDIGO classification and Liaño's Individual Severity Index (ISI).</p><p id="par0050" class="elsevierStylePara elsevierViewall">We have focused on AKI because of the impact of prognosis on the cost of patient care and therapeutic outcomes, in terms of morbidity and mortality. Prognosis in AKI is important in order to estimate the clinical evolution of each patient with this disease, the evolution of disease severity, and the effectiveness of the treatments used.</p><p id="par0055" class="elsevierStylePara elsevierViewall">A number of early prognosis systems have been evaluated, but the ISI has been shown to have the greatest prognostic power for tubular necrosis. Various studies have compared the prognostic accuracy of the ISI in critical AKI patients with other severity scales (SAPS II, APACHE II). Good correlation was observed between all the scales studied, but the ISI was found to be the most practical instrument. Earlier studies have confirmed this simple AKI-specific index to be a valid and reliable method of correctly determining the prognosis of patients with AKI.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">8,9</span></a> The ISI can also be used repeatedly after diagnosis to re-evaluate the patient's progress, severity, and response to treatment during their hospital stay. The following parameter-based formula is used to calculate the ISI scale:ISI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.032(age in decades)<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>0.09(if sex<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>male)<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>0.11(if toxic AKI)<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>0.11(if oliguria)<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>0.12(if jaundice)<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>0.15(if coma)<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>0.15(if normal consciousness)<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>0.18(if mechanical ventilation)<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>0.21</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and method</span><p id="par0060" class="elsevierStylePara elsevierViewall">Retrospective observational study of 1115 patients admitted to the CCU for any reason from 1 January 2012 to 1 January/2015. Patients were followed-up until death or the end of the study (15/07/2015). Mean follow-up was 18<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.24 months.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The following variables were analysed:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">Clinical–epidemiological: age, gender, medical specialty, medical/surgical cause of CCU admission, average stay in CCU (days), onset of AKI, KDIGO stage of AKI, need for haemodialysis, death in CCU, date of last evaluation, status at last evaluation, CCI<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">1,2</span></a> score, ISI score in patient with AKI,<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">10,11</span></a> presence of shock, need for mechanical ventilation, inotropes, diuretics, presence of previous chronic kidney disease (CKD) and KDIGO stages of CKD (stage 5 was excluded from the analysis).</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall">Historical: diabetes, heart failure, COPD, ischaemic heart disease, liver disease, dementia, hypertension, stroke, peripheral vascular disease, ulcerative disease, cancer and AIDS.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall">Analytical: baseline creatinine (defined as the mean of all determinations in the previous 365 – 7 days), creatinine on hospital admission, peak creatinine in CCU, creatinine at CCU discharge, creatinine at discharge home, bilirubin, albumin, haemoglobin, leukocytes, segmented neutrophils, platelets, sodium, potassium, chlorine, pH, bicarbonate and glomerular filtration rate (GFR) estimated according to the CKD-EPI formula calculated at baseline and at CCU discharge.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0085" class="elsevierStylePara elsevierViewall">Liver function parameters: baseline pre-admission GFR calculated using the CKD-EPI formula to establish the pre-admission stage of CKD according to the KDIGO scale, severity of AKI according to KDIGO criteria (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), ISI score during the AKI episode, and need for dialysis up to 15 July 2015.</p></li></ul></p><p id="par0090" class="elsevierStylePara elsevierViewall">Clinical–epidemiological and analytical variables were tested using descriptive statistical methods. The qualitative variables were the absolute (<span class="elsevierStyleItalic">n</span>) and relative (%) frequencies of all valid cases, and the quantitative variables were the mean and standard deviation of these frequencies if they followed a normal distribution (Kolmogorov–Smirnov test). In the case of non-normal variables, the median was used as a measure of central tendency and the quartiles were also calculated.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Univariate data were analysed with hypothesis testing, comparing proportions when both variables were qualitative (Chi square, Fisher's test, and in the case of multiple comparisons, the Bonferroni method), comparing means when one variable was quantitative (Student's <span class="elsevierStyleItalic">T</span>, ANOVA), and comparing distribution functions in the case of non-normally distributed variables (<span class="elsevierStyleItalic">U</span> Mann–Whitney or Kruskal–Wallis test).</p><p id="par0100" class="elsevierStylePara elsevierViewall">A multivariate logistic regression analysis was performed to select the variables associated with the onset of AKI during the CCU stay, using AKI as a dependent variable.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The impact of onset of AKI on mortality both in the CCU and after post-discharge follow-up was tested using a multivariate Cox regression model.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Variables showing statistically significant differences in previous tests or in other studies were used as independent variables. Finally, a concordance analysis (kappa index) was performed on the different AKI classification criteria: RIFLE, AKIN and KDIGO. The statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) 21, Chicago, Illinois. Significance was set at <0.05.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0115" class="elsevierStylePara elsevierViewall">Most (61.3%) of the 1115 patients included in the study were men. The mean age was 69.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>15 years (range 18–102).</p><p id="par0120" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the clinical and analytical variables of study patients according to whether or not they presented AKI during their CCU stay.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">The percentage of men was similar in both groups. Patients presenting AKI were older (average 6.6 years older) and presented higher baseline creatinine values, and lower levels of albumin and haemoglobin on analytical tests.</p><p id="par0130" class="elsevierStylePara elsevierViewall">The mean CCI score was 6.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9. Patients with a CCI score of <span class="elsevierStyleMonospace">></span>6 were twice as likely (56.9%) to develop AKI compared to patients with score of ≤6 (28.1%). This difference was statistically significant. The average length of CCU stay in these patients was higher, and their average survival was lower.</p><p id="par0135" class="elsevierStylePara elsevierViewall">A total of 953 patients (85.47%) were admitted through the emergency department, and 162 (14.52%) were scheduled admissions; in this group, 427 (44.80%) and 59 (36.40%) patients, respectively, developed AKI.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Most patients were cardiac (33.8%), general surgery (24.1%) and internal medicine (20.6%) cases.</p><p id="par0145" class="elsevierStylePara elsevierViewall">A total of 738 patients (66.18%) were admitted for medical reasons, and 377 (33.72%) for surgical reasons; in this group, 309 (41.86%) and 177 patients (46.94%), respectively, developed AKI.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Of the 1115 study patients, 486 (43.6%) met the KDIGO criteria for AKI. Among patients who developed AKI, the greater proportion were admitted for cardiorespiratory arrest (72.7%), septic shock (57.80%) and cardiac arrhythmias (55.6%).</p><p id="par0155" class="elsevierStylePara elsevierViewall">In most cases, AKI was attributed to prerenal factors and acute tubular necrosis, bearing in mind that these aetiologies were established retrospectively. However, the presumptive diagnosis was based on individual evolution: patients showing rapid recovery were included in the pre-renal group, while those with slower evolution were included in the acute tubular necrosis group.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Good concordance was observed between all the AKI classification systems. The concordance between the AKIN vs RIFLE showed a kappa index of 1. The concordance between KDIGO vs RIFLE and AKIN showed a kappa of 0.96.</p><p id="par0165" class="elsevierStylePara elsevierViewall">The distribution of AKI stages (KDIGO criteria) was as follows: stage I<span class="elsevierStyleSmallCaps">,</span> 21.1% (235 patients); stage I<span class="elsevierStyleSmallCaps">I</span>, 13.8% (154 patients), and stage <span class="elsevierStyleSmallCaps">III</span>, 8.7% (97 patients).</p><p id="par0170" class="elsevierStylePara elsevierViewall">A total of 307 patients (27.53%) had a history of CKD: 141 patients with stage 3A, 97 patients with stage 3B, 53 with stage 4, and 16 with stage 5; the latter were excluded from the analysis.</p><p id="par0175" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows how the incidence of AKI increased almost linearly in parallel with the decrease in baseline GFR. Episodes of AKI were particularly common in patients with GFR <60<span class="elsevierStyleHsp" style=""></span>ml/min.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0180" class="elsevierStylePara elsevierViewall">A total of 35 patients (7.2% of cases with AKI) required haemodialysis; in 23 of these, follow-up showed the need for long term haemodialysis.</p><p id="par0185" class="elsevierStylePara elsevierViewall">The main predictor of onset of AKI in the CCU was a history of CKD, which increased the risk 6-fold, followed by shock, admission due to surgery, male gender, and finally, CCI score (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0190" class="elsevierStylePara elsevierViewall">The variables age, diabetes, heart failure, albumin, haemoglobin and COPD were shown to be non-significant in the univariate study, and were therefore not included in the logistic regression model.</p><p id="par0195" class="elsevierStylePara elsevierViewall">The average CCU stay for non-AKI patients was 7.141<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.273 days, while that of patients with KDIGO stage <span class="elsevierStyleSmallCaps">I</span> was 7.421<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.432 days, stage <span class="elsevierStyleSmallCaps">II</span>was 9.123<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.350 days, and stage <span class="elsevierStyleSmallCaps">III</span> was 9.608<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.382 days (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001; no AKI versus the other groups).</p><p id="par0200" class="elsevierStylePara elsevierViewall">CCU stay among patients that developed AKI was on average 1.256 days longer than those in the non-AKI group.</p><p id="par0205" class="elsevierStylePara elsevierViewall">In total, 72.7% of patients were transferred to the ward, 21.1% were referred to another hospital (17.9% due to catheterisation), and the rest died in the CCU (5.6%) or were discharged home (0.6%).</p><p id="par0210" class="elsevierStylePara elsevierViewall">Sixty-five patients (5.83%) died during their stay in the CCU, of whom 60 presented an episode of AKI. By the end of follow-up (mean 18<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.24 months), 262 patients had died, of whom 194 (74.05%) had presented an episode of AKI in the CCU.</p><p id="par0215" class="elsevierStylePara elsevierViewall">By the end of the study, the percentage of non-survivors was significantly lower in the non-AKI vs AKI group, and death rates increased progressively in parallel with the severity of AKI (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0220" class="elsevierStylePara elsevierViewall">By the end of post-discharge follow-up, survival was 6.4 months lower in the group of patients that developed AKI during their stay in the CCU vs non-AKI patients (AKI 15.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.5 months vs no AKI 21.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.3 months) (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0225" class="elsevierStylePara elsevierViewall">We used a multivariate Cox regression model to analyse the impact of AKI on mortality. Variables showing statistically significant differences in previous tests: AKI (KDIGO)/no AKI, CCI, ISI, haemoglobin, albumin (<2.5 vs <span class="elsevierStyleMonospace">></span>2.5), CKD, gender and age (years), were included in this model.</p><p id="par0230" class="elsevierStylePara elsevierViewall">The likelihood of surviving the CCU decreased in patients with AKI (HR: 5.44; 95% CI 1.70–17.39), and also decreased in parallel with an increase in severity (ISI) (HR: 10.29; 95% CI 3.34–31.76). This means that presentation of AKI and ISI score were predictors of mortality. Diabetes, CKD, haemoglobin, gender, CCI score, albumin and age at admission did not affect survival.</p><p id="par0235" class="elsevierStylePara elsevierViewall">By the end of follow-up, we observed that the probability of survival decreased in patients with AKI (HR: 1.72; 95% CI 1.14–2.61), with higher ISI score (HR: 9.6; 95% CI 5.07–18.20), with a CCI score of <span class="elsevierStyleMonospace">></span>6 (HR: 1.09; 95% CI 1.03–1.15), incrementally for each year over 70 years (HR: 1.03; 95% CI 1.01–1.04), with albuminaemia <span class="elsevierStyleMonospace">></span>2.5 (HR: 1.69; 95% CI 1.13–2.53), male gender (HR: 1.38; 95% CI 1.06–1.79) and with previous CKD (HR: 1.56; 95% CI 1.02–2.38).</p><p id="par0240" class="elsevierStylePara elsevierViewall">At the end of the study, a history of CKD and onset of AKI in the CCU were found to be predictors of long-term mortality. The other variables were the CCI score, male gender, serum albumin <span class="elsevierStyleMonospace"><</span>2.5<span class="elsevierStyleHsp" style=""></span>g/dl, age, and ISI score. The latter was the main predictor (HR: 9.6), insofar as each 0.1 increment in the ISI score increased the likelihood of death during follow-up by 26%.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0245" class="elsevierStylePara elsevierViewall">In our study, patients who developed AKI in the CCU were men with an average age of 75 years and a high CCI score (6.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9). These results coincide with those of other authors, such as Zhang and Wang.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">12</span></a></p><p id="par0250" class="elsevierStylePara elsevierViewall">The number of surgical patients developing AKI was 5.06% higher than those admitted for medical reasons. In general, these patients require a longer stay, more invasive techniques, and presented more infectious complications. In these terms, our results coincide with those Mas et al.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">13</span></a> in their study of ICUs in Spain (138,000 patients), in which emergency and surgical patients predominated.</p><p id="par0255" class="elsevierStylePara elsevierViewall">In this study, although episodes of AKI were more frequent in postoperative patients, this did not affect the higher mortality rates in this subgroup. However, incidence of AKI in a particular sub-population is not necessarily linked to mortality in the same group, given that “surgical cause” encompasses different aetiologies of varying severity in each particular case. The FRAMI study, in contrast, showed that incidence of AKI in the ICU was higher among patients admitted for medical reasons.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a></p><p id="par0260" class="elsevierStylePara elsevierViewall">Continuous monitoring and observation will allow clinicians to promptly diagnose AKI and start treatment, sometimes even before admission to the CCU. Once in the unit, the ISI can be used to determine AKI prognosis and to dynamically monitor the severity of the disease and response to treatment. Therefore, the possibility of using AKI prognosis scales to prevent onset of the disease warrants further investigation.</p><p id="par0265" class="elsevierStylePara elsevierViewall">We observed good correlation between the RIFLE, AKIN and KDIGO scales. We diagnosed 23 more AKI patients using the KDIGO scale than with RIFLE or AKIN, which increased the number of patients diagnosed with mild renal insufficiency.</p><p id="par0270" class="elsevierStylePara elsevierViewall">Incidence of AKI in our series was 43.6%, a finding that coincides with other studies<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">14,15</span></a>; we were unable to compare our results with other studies performed in CCUs similar to ours.</p><p id="par0275" class="elsevierStylePara elsevierViewall">In patients with insufficient renal blood flow, kidney damage may be minimised by promptly restored perfusion. In critical care, small increments in serum creatinine could increase the sensitivity of a diagnosis of abrupt (within 48<span class="elsevierStyleHsp" style=""></span>h) AKI. Whether or not improving the early diagnosis of stage <span class="elsevierStyleSmallCaps">I</span> AKI will improve the quality of care by optimising fluid and haemodynamic management and avoiding nephrotoxins is a topic that merits further research.</p><p id="par0280" class="elsevierStylePara elsevierViewall">We also observed a higher incidence of patients with severe AKI than other studies. This may be due to the characteristics of our patients, since critical patients that need advanced life support measures are admitted to the CCU.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">16</span></a> Thirty-five of our patients (7.2% of cases with AKI) required haemodialysis. Patients with CKD stages G4 and G3B presented a higher incidence of severe and moderate AKI. This echoes the results of other studies.<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">17,18</span></a></p><p id="par0285" class="elsevierStylePara elsevierViewall">We agree with the recommendation of other authors<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">19</span></a> to provide extra monitoring for AKI in the CCU in patients admitted for surgical reasons, with advanced age, high comorbidity, particularly systemic vascular involvement and previous pharmacological treatment (mainly RAAS blockers and diuretics), reduced functional reserve and renal compliance in the context of CKD, and with processes that involve low cardiac output (fluid depletion, hypoalbuminaemia or other situations that involve renal hypoperfusion).</p><p id="par0290" class="elsevierStylePara elsevierViewall">In our series, patients who developed AKI required longer CCU stays, with the greater consumption of resources that this entails. Most authors agree that patients with AKI require longer hospital stays. This is due to the seriousness of the disease and the associated complications that delay the recovery of renal function.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">20</span></a></p><p id="par0295" class="elsevierStylePara elsevierViewall">As in other studies,<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">21,22</span></a> overall survival in our sample was 6.4 months lower among patients admitted to the CCU with AKI. Increase in the severity of AKI was linked to an increase in the in-CCU mortality rate; comorbidity (CCI), which is a prognosis factor for mortality, is significantly higher in elderly patients.</p><p id="par0300" class="elsevierStylePara elsevierViewall">In the multivariate analysis of survival during the CCU stay, the probability of decreased survival in patients with AKI is 5.5 higher and the risk is 10 times higher for every ISI score increment.</p><p id="par0305" class="elsevierStylePara elsevierViewall">The end-of-study multivariate analysis showed that the risk of mortality increased by 3% per year <span class="elsevierStyleMonospace">></span>70 years, while male gender increased the risk by 38%. Some authors have not found advanced age to be an independent risk factor for death, although it is a risk factor when associated with the underlying disease. Comorbidity, measured using the CCI, is significantly higher in this group of patients; the probability of survival decreases by 9% for each increment in CCI score.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">23</span></a></p><p id="par0310" class="elsevierStylePara elsevierViewall">We agree with other studies reporting that patients with serum albumin <2.5<span class="elsevierStyleHsp" style=""></span>mg/dl are less likely to survive.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">24</span></a> ICU patients frequently present cardiovascular collapse and inflammation. The baseline clinical complexity of these patients, oliguria and malnutrition-inflammation, are the main prognostic and mortality factors in AKI. In our study, the risk of death during follow-up increased by 56% in patients with CKD. Similar results were reported by Ortiz Librero et al.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">2</span></a></p><p id="par0315" class="elsevierStylePara elsevierViewall">AKI-related mortality in the ICU has remained at the same high level reported 20 years ago (50–60%), although the causes of death are different. In recent years, medical and nephrotoxic causes have increased considerably, while obstetric causes have almost disappeared. The incidence of postoperative AKI, meanwhile, particularly when associated with sepsis, hypotension and/or ischaemic factors, continues to be very high.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">25</span></a></p><p id="par0320" class="elsevierStylePara elsevierViewall">We agree with Lins et al.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">26</span></a> that prognostic models for AKI must be used. ISI score is higher among patients with all 3 stages of AKI. Liaño explains that AKI usually occurs in the context of diseases that in themselves can be fatal; in this regard, the ISI is a good predictive tool.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">10</span></a></p><p id="par0325" class="elsevierStylePara elsevierViewall">Most studies of AKI in the ICU focus on mortality and renal recovery during ICU stay and at the time of discharge home; in other words, in the context of an acute, short-term disease. Chertow et al.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">27</span></a> developed predictive 60-day mortality models in patients with AKI for use at 3 different times: day of diagnosis of AKI, day of consultation with a nephrologist, and day of onset of renal replacement therapy (RRT). However, this method is for use in patients with more severe AKI, and is hard to use in those with less severe disease.</p><p id="par0330" class="elsevierStylePara elsevierViewall">In our study, patients were followed up for an average of 18<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.24 months, which gave us a broad perspective of the evolution of various disease-related aspects. Regarding long-term mortality, 262 patients (23.5%) had died by15 July 2015, of whom 194 had developed AKI during their CCU stay. These results are consistent with other studies.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">28</span></a></p><p id="par0335" class="elsevierStylePara elsevierViewall">The results of our multivariate analysis of mortality-related variables are largely similar to those reported in the FRAMI study.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">14</span></a> The authors of FRAMI, however, observed a relationship with diabetes. This could due to the characteristics of our respective samples, which may differ in terms of some factors that were not controlled by the study design.</p><p id="par0340" class="elsevierStylePara elsevierViewall">It is striking that some variables, such as diabetes, together with heart failure, COPD or haemoglobin, did not significantly influence survival in the CCU or subsequent follow-up. Although we recruited a large sample, which gives our study adequate statistical power, its retrospective nature may conceal biases that have an impact on this result. More studies are needed to obtain evidence in this regard.</p><p id="par0345" class="elsevierStylePara elsevierViewall">It is also important to bear in mind that the factors influencing the evolution of patients with AKI are not necessarily the same in the early and late stages of the disease, as these constitute different clinical scenarios. Therefore, although in our study only 2 variables were independently related to in-CCU mortality (onset of AKI and ISI score), the multivariate model selected 7 significant follow-up variables: AKI and ISI, in addition to CCI score, serum albumin <2.5<span class="elsevierStyleHsp" style=""></span>g/dl, previous history of CKD, male gender, and age. The presence of AKI in both models highlights the prognostic importance of this complication both in the short and long term.</p><p id="par0350" class="elsevierStylePara elsevierViewall">In our series, mortality was 32.3% among patients with AKI. These patients also have a higher probability (72%) of shorter survival. Our results are similar to those of other studies reporting high mortality rates in surgical patients and AKI.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">29</span></a></p><p id="par0355" class="elsevierStylePara elsevierViewall">Given the high mortality rate and the lack of specific and effective treatment for these patients, every effort must be made to identify risk factors for AKI as soon as possible.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">30</span></a></p><p id="par0360" class="elsevierStylePara elsevierViewall">The limitations of this study stem from its observational nature. First, due to its retrospective design, we cannot rule out possible selection bias and errors in the collection and interpretation of the clinical history data. Although the cohort studied was representative of the local population, all study patients were recruited at a single hospital. Another problem involves the difference between the characteristics of CCUs and other ICUs.</p><p id="par0365" class="elsevierStylePara elsevierViewall">The absence of validated severity scales, such as APACHE II, SAPS or SOFA for critical AKI patients is another limitation. However, this was compensated by the ISI, which is a specific scale validated for AKI. Unlike the APACHE II, which cannot be used to evaluate patients over time,<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">31</span></a> the study of dynamic changes in ISI score has a prognostic value.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">8,9</span></a></p><p id="par0370" class="elsevierStylePara elsevierViewall">Finally, our study is not free from lead-time bias, in other words, the incorrect estimation of risk at the time of admission to the ICU due to the results of previous therapeutic measures.</p><p id="par0375" class="elsevierStylePara elsevierViewall">In conclusion, our study shows the prognostic value of detecting AKI in patients admitted to a CCU. This complication is extremely common, increases the average length of stay and associated medical costs, and is detrimental to survival both in the CCU and during post-discharge follow-up. Therefore, once the risk factors of AKI have been described, measures should be taken to enable the prevention and early diagnosis of this disease.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0380" class="elsevierStylePara elsevierViewall">The study received a scholarship from the <span class="elsevierStyleGrantSponsor" id="gs1">Official College of Physicians of Zaragoza</span>.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0385" class="elsevierStylePara elsevierViewall">The authors have no potential conflicts of interest related to the contents of this article.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1042026" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec994793" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1042025" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec994792" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and method" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "xack351457" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-08-23" "fechaAceptado" => "2018-02-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec994793" "palabras" => array:3 [ 0 => "Acute kidney injury" 1 => "Reanimation and special care unit" 2 => "Chronic kidney disease" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec994792" "palabras" => array:3 [ 0 => "Fracaso renal agudo" 1 => "Unidad de Reanimación y Cuidados Especiales" 2 => "Enfermedad renal crónica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The main objective of the study is to perform an analysis on the incidence, predictive variables, and severity of acute kidney injury (AKI) and its impact on the morbidity and mortality of patients in the Resuscitation and Special Care Unit (RSCU) of a regional hospital.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective observational study was conducted that included all patients admitted from 1 January 2012 to 1 January 2015 (1115 patients). The follow-up was until 15 July 2015. A descriptive statistical analysis of clinical–epidemiological and analytical variables was carried out. An analysis was then performed AKI in RSCU and mortality, as well as the agreement between the Risk, Injury, Failure, Loss of Kidney Function, and End-stage Kidney Disease (RIFLE)/Acute Kidney Injury Network (AKIN)/Kidney Disease: Improving Global Outcomes (KDIGO) criteria (kappa index). A multivariate logistic regression analysis was performed to select the variables associated with the presentation of AKI in RSCU and a univariate (Kaplan–Meier) and multivariate survival analysis (Cox regression). The statistical analysis was carried out using the statistical package SPSS 21.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">During admission to RSCU, 486 patients presented with AKI (43.6%), of which 21% were in stage I, 13.8% in stage II, and in stage III 8.7%. A high level of agreement was observed between the RIFLE/AKIN/KDIGO criteria. The variables that were related to the presence of AKI, are male (OR: 1.37; 95% CI: 1.02–2.30), to high Charlson Comorbidity Index (OR: 1.17; 95% CI: 1.09–1.26), carriers of chronic kidney disease (OR: 5.99; 95% CI: 4.58–8.18), admission due to surgery (OR: 1.69; 95% CI: 1.24–2.30), and shock (OR: 4.70; 95% CI: 3.34–6.61). The probability of survival during admission in RSCU decreases in patients with AKI (HR: 5.44; 95% CI: 1.70–17.39), and as the individual severity index of Liaño increases (HR: 10.29; 95% CI: 3.34–31.76). The probability of survival at the end of follow-up after hospital discharge decreases in patients with AKI (HR: 1.72; 95% CI: 1.14–2.61), as the individual severity index of Liaño increases (HR: 9.6; 95% CI: 5.07–18.20), the Charlson Comorbidity Index >6 (HR: 1.09; 95% CI: 1.03–1.15), low serum albumin <2.5<span class="elsevierStyleHsp" style=""></span>mg/dL (HR: 1.69; 95% CI: 1.13–2.53), age by year >70 years (HR: 1.03; 95% CI: 1.01–1.04), males (HR: 1.38; 95% CI: 1.06–1.79) and carriers of previous chronic kidney disease (HR: 1.56; 95% CI: 1.02–2.38).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This study shows the presentation of an episode of AKI was an independent factor associated both with mortality during admission to RSCU, and later after hospital discharge. It is necessary to know the risk factors of this complication in order to adopt preventive measures.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo principal del estudio es analizar la incidencia, las variables predictoras y gravedad del fracaso renal agudo (FRA) y su repercusión en la morbimortalidad de los pacientes de la Unidad de Reanimación y Cuidados Especiales (URCE) de un hospital comarcal.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional retrospectivo que incluye a todos los pacientes ingresados del 1/1/2012 al 1/1/2015 (1.115 pacientes). El seguimiento fue hasta el 15/07/2015. Se llevó a cabo una estadística descriptiva de variables clinicoepidemiológicas y analíticas. Se realizó el análisis de FRA en URCE y la concordancia entre los sistemas RIFLE/AKIN/KDIGO (índice kappa). Para seleccionar las variables asociadas a la presentación de FRA en URCE, se realizó un análisis de regresión logística multivariante y para el análisis de la repercusión del FRA en la mortalidad, tanto en URCE como al final del seguimiento; se llevó a cabo un análisis de supervivencia univariante (Kaplan–Meier) y multivariante (regresión de Cox). El análisis estadístico se realizó con el paquete estadístico SPSS 21.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Durante el ingreso en URCE, 486 pacientes presentaron FRA (43,6%), de los cuales, el 21% se encontraban en estadio <span class="elsevierStyleSmallCaps">i</span>, el 13,8% en estadio <span class="elsevierStyleSmallCaps">ii</span> y el 8,7% en estadio <span class="elsevierStyleSmallCaps">iii</span>. Observamos una elevada concordancia entre los sistemas RIFLE (Risk, Injury, Failure, Loss of Kidney Function, and End-stage Kidney Disease)/AKIN (Acute Kidney Injury Network)/KDIGO (Kidney Disease: Improving Global Outcomes). Las variables que se relacionan con presencia de FRA son varones (OR: 1,37; IC95%: 1,02-2,30), con el índice de comorbilidad de Charlson elevado (OR: 1,17; IC95%: 1,09-1,26), portadores de enfermedad renal crónica (OR: 5,99; IC95%: 4,58-8,18), ingreso por causa quirúrgica (OR: 1,69; IC95%: 1,24-2,30) y shock (OR: 4,70; IC95%: 3,34-6,61). La probabilidad de supervivencia, durante el ingreso en URCE, disminuye en pacientes con FRA (HR: 5,44; IC95%: 1,70-17,39) y según aumenta el índice de severidad individual de Liaño (HR: 10,29; IC95%: 3,34-31,76). La probabilidad de supervivencia, al final del seguimiento, disminuye en pacientes con FRA (HR: 1,72; IC95%: 1,14-2,61), según aumenta el índice de severidad individual de Liaño (HR: 9,6; IC95%: 5,07-18,20), el índice de comorbilidad de Charlson<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>6 (HR: 1,09; IC95%: 1,03-1,15), la albuminemia<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>2,5<span class="elsevierStyleHsp" style=""></span>mg/dl (HR: 1,69;IC95%: 1,13-2,53), la edad por año<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>70 años (HR: 1,03; IC95%: 1,01-1,04), ser varones (HR: 1,38; IC95%: 1,06-1,79) y ser portadores de enfermedad renal crónica previa (HR: 1,56; IC95%: 1,02-2,38).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En nuestro estudio, la presentación de un episodio de FRA fue un factor asociado de modo independiente, tanto con la mortalidad durante el ingreso en URCE como durante el seguimiento tras el alta hospitalaria. Es necesario conocer los factores de riesgo de esta complicación para adoptar medidas preventivas.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Esteban Ciriano ME, Peña Porta JM, Vicente de Vera Floristán C, Olagorta García S, Álvarez Lipe R, Vicente de Vera Floristán JM. Morbimortalidad del fracaso renal agudo en la Unidad de Cuidados Críticos de un hospital comarcal. Rev Esp Anestesiol Reanim. 2018;65:314–322.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1140 "Ancho" => 1511 "Tamanyo" => 92940 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">KDIGO stages of AKI (creatinine-based CKD-EPI equation).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 839 "Ancho" => 1642 "Tamanyo" => 61658 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Percentage of deaths according to AKI-KDIGO at end of follow-up (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001; no AKI vs AKI).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1436 "Ancho" => 1504 "Tamanyo" => 73444 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Survival curves at the end of follow-up (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p>" ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">RIFLE criteria \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AKIN criteria<br>Stage \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">KDIGO guidelines<br>Stage \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Serum creatinine \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Urine output \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">R risk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5–1.9-fold increase in baseline creatinine or ≥0.3<span class="elsevierStyleHsp" style=""></span>mg/dL (≥26<span class="elsevierStyleHsp" style=""></span>μmol/) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.5<span class="elsevierStyleHsp" style=""></span>ml/kg/h<br>for 6–12<span class="elsevierStyleHsp" style=""></span>h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">I injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2–2.9-fold increase in baseline creatinine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.5<span class="elsevierStyleHsp" style=""></span>ml/kg/h<br>for ≥12<span class="elsevierStyleHsp" style=""></span>h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">F failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3-fold increase in baseline creatinine or ≥4<span class="elsevierStyleHsp" style=""></span>mg/dL (≥353.6<span class="elsevierStyleHsp" style=""></span>μmol) or start of renal replacement therapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.3<span class="elsevierStyleHsp" style=""></span>ml/kg/h<br>for ≥24<span class="elsevierStyleHsp" style=""></span>h or anuria <span class="elsevierStyleMonospace">></span>12<span class="elsevierStyleHsp" style=""></span>h \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">L loss \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Persistent kidney failure <span class="elsevierStyleMonospace">></span>4 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">E end-stage kidney failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Persistent kidney failure <span class="elsevierStyleMonospace">></span>3 weeks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1770330.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Classification of acute kidney injury according to RIFLE, AKIN and KDIGO guidelines.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">AKI: acute kidney injury; CCI: Charlson Comorbidity Index; CCU: Critical Care Unit; GFR: glomerular filtration.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">AKI (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>486) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No AKI (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>629) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75.33<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.11 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69.31<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.299 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Men \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.026 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline creatinine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.31<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.88<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.86<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.88<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine at admission to CCU \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.327<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.65<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.92<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.23<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Peak creatinine in CCU \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.69<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.9<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.95<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.24<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine at CCU discharge \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.83<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.26<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.85<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.23<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine at discharge home \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.53<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.99<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.86<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.23<span class="elsevierStyleHsp" style=""></span>mg/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Baseline GFR CKD-EPI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.57<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.76<span class="elsevierStyleHsp" style=""></span>ml/min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.61<span class="elsevierStyleHsp" style=""></span>ml/min \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Albumin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.56<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.7<span class="elsevierStyleHsp" style=""></span>g/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.679<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.74<span class="elsevierStyleHsp" style=""></span>g/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Haemoglobin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.14<span class="elsevierStyleHsp" style=""></span>g/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.19<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.13<span class="elsevierStyleHsp" style=""></span>g/dl \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.017 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leukocytes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13,707<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6643 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11,806<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6290 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Platelets \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">208,902<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>97,493 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">203,316<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>94,461 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ns \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sodium \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">138.85<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">137.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6.4<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.016 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Potassium \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.522<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.9<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.596<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.9<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.047 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chlorine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">104<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">104<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ns \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.1<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.1<span class="elsevierStyleHsp" style=""></span>mmHg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ns \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bicarbonate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.23<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.38<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.8<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lactate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.5<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.63<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.3<span class="elsevierStyleHsp" style=""></span>mmol/1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CCI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.43<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stay in CCU \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.97 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.14<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.27 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean survival \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.15<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12.5 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.53<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>11.29 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1770331.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Clinical and analytical variables of study patients according to whether or not they presented AKI during their CCU stay.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">CCI: Charlson Comorbidity Index; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; HF: heart failure; OR: odds ratio.</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Statistically significant values shown in bold.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI</th><th class="td" title="table-head " align="left" valign="top" scope="col"><span class="elsevierStyleItalic">p</span>-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lower \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Upper \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Sex</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Men vs women \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.85 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.038</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.267 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CCI</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.000</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">CKD</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>CKD vs no CKD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.000</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Reason admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Surgical vs medical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.001</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Diabetes</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes vs no \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.259 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Albumin</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><2.5 vs <span class="elsevierStyleMonospace">></span>2.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.468 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Haemoglobin</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.638 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Shock at admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Yes vs no</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.000</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">HF vs no HF</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.273 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">COPD vs no COPD</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.446 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1770332.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Variables associated with onset of AKI in the CCU (logistic regression model).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib0160" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[accessed 26.10.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Updating and validating the Charlson Comorbidity Index and score for risk adjustment in hospital discharge abstracts using data from 6 countries" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. 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Your support and generosity have made this study possible.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006500000006/v1_201806130410/S2341192918300751/v1_201806130410/en/main.assets" "Apartado" => array:4 [ "identificador" => "34051" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006500000006/v1_201806130410/S2341192918300751/v1_201806130410/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192918300751?idApp=UINPBA00004N" ]
