• Natáia Maria da Silva Fernandes, Patrícia dos Santos Pinto, Thiago Bento de Paiva Lacet, Dominique Fonseca Rodrigues, Marcus Gomes Bastos, Sérgio Reinaldo Stella, and Miguel Cendoroglo Neto.
• Universidade Federal de Juiz de Fora-UFJF, Juiz de Fora, MG, Brazil.
• Rev Assoc Med Bras. 2009 Jul 1; 55 (4): 434-41.

IntroductionAcute renal failure (ARF) remains highly prevalent with a high rate of morbidity and mortality.Objectiveof this study was to compare use of the APACHE II scoring prognosis with that of the ATN-ISS to determine whether the APACHE II could be used for patients with ARF outside the ICU.MethodsFor this purpose, 205 patients with ARF were accompanied in a prospective cohort. Demographic data, preexisting conditions, organ failure and characteristics of ARF were analyzed. The prognostic scores were performed with the assessment of a nephrologist.ResultsThe mean age was 52 +/- 18 years, 50% were male, 69% were white, 45% were treated in ICU and 55% in other units. Mortality in the ICU group was 85% and in the non-ICU group 18%. Factors that correlated with higher mortality were more prevalent in the ICU group: age, male, hospitalization with ARF, organ failure, sepsis, septic IRA, oliguria and need of dialysis. Overall, the prognostic markers were the same for both the ICU and non-ICU groups. The discrimination with the APACHE II was similar in both, ICU and non-ICU groups and calibration was better in the non-ICU group. The ATN-ISS achieved good discrimination in both the ICU and non-ICU groups, but, regarding calibration, there was a discreet over estimating of mortality in the non-ICU group. The ATN-ISS showed a greater capacity for discrimination than the APACHE II in both the ICU and non-ICU groups.ConclusionIt was concluded that the APACHE II and ATN-ISS scores could be used for stratification of risk in patients with ARF treated outside of the ICU in Brazil.

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