Abstract

Background and Aims

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Epidemiological studies have shown that the incidence of sepsis is increasing and therefore it is a public health problem. AKI is often associated with critical illnesses such as sepsis, and is associated with prolonged hospital stay, need for intensive care, increased morbidity and mortality. Although the mechanism of sepsis-induced AKI is not fully understood, it is thought that it has a different pathogenesis and requires a different approach and therefore it has been the focus of the studies. The aim of this study was to compare the criteria of SIRS and qSOFA in patients with suspected infection to determine which is more valuable in predicting sepsis associated AKI.

Method

SIRS and qSOFA scores of 120 patients with sepsis who were admitted to the Emergency Department of Marmara University Hospital were calculated at the time of admission. Age, gender and chronic diseases were recorded. The laboratory values at the time of admission and follow-up were recorded and the factors associated with the development of AKI were investigated by statistical analysis.

Results

Of the patients evaluated in the study, 60.8% (n = 73) were male and 39.2% (n = 47) were female. The median age was 66 (18-89) years. About 96% (n = 116) of the patients met the SIRS criteria, 54.2% (n = 65) met the qSOFA criteria, and 51.7% (n = 62) met both the SIRS and qSOFA criteria. AKI was found in 62.5% (n = 75) of the patients. According to AKIN staging, 40 (53.3%) patients had stage 1, 19 (25.3%) patients had stage 2 and 16 (21.4%) patients had stage 3 AKI. There was no correlation between SIRS criteria and development of AKI. However, all patients who received 3 points from qSOFA criteria developed AKI. According to the results of multivariate analysis, age, abnormal mental status and procalcitonin were associated with development of AKI.

Conclusion

Sepsis-associated AKI is related with deterioration in clinical outcomes, early diagnosis and treatment is important. According to our results, the risk of AKI is higher in patients with qSOFA score 3 but not SIRS criterias.

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