• Yu-Feng Lin, Wen-Je Ko, Vin-Cent Wu, Yih-Sharng Chen, Yung-Ming Chen, Fu-Chang Hu, Chih-Chung Shiao, Ming-Shiou Wu, Yung-Wei Chen, Wen-Yi Li, Tao-Min Huang, Kwan-Dun Wu, Tzong-Shinn Chu, and NSARF Study Group.
• Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taipei, Taiwan, ROC.
• Blood Purif. 2008 Jan 1; 26 (6): 547-54.

BackgroundA predictive model for hospital mortality in postoperative acute renal failure (ARF) patients requiring renal replacement therapy (RRT) may aid clinicians' therapeutic decision-making and research design.MethodsA prospective observational study of 398 postoperative ARF patients requiring RRT was conducted in four hospitals. The derivation cohort consisted of 334 patients recruited between January 2002 and December 2005. The validation cohort consisted of 64 patients recruited between January 2006 and December 2006.ResultsThe hospital mortality rates for the derivation and validation cohorts were 65.6 and 62.5%, respectively. A modified Sequential Organ Failure Assessment (SOFA) score was constructed at the commencement of RRT by a formula of serum lactate level (mM) + 2 x (generic SOFA score) + 3 x (age per decade) + 8 (if mechanical circulatory support required) + 10 (if total parenteral nutrition required) + 11 (if status postcardiopulmonary resuscitation) + 13 (if positive sepsis sign). The area under the receiver operating characteristic curve of the model for the derivation and validation cohorts was 0.804 and 0.839, respectively.ConclusionThis validated score at dialysis commencement might assist clinicians in estimating hospital mortality, planning future clinical trials, and providing quantitative guidance for decision making in postoperative ARF patients requiring RRT.Copyright 2008 S. Karger AG, Basel.

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