Abstract:
Objective To analyze the value of the Hepatic Failure, Lactate, Norepinephrine, Medical Condition and Creatinine score (HELENICC score) in predicting early mortality of sepsis-related acute kidney injury (S-AKI) patients with continuous renal replacement therapy (CRRT).
Methods From January 2019 to December 2022, 99 S-AKI patients with CRRT in the Intensive Care Unit (ICU) of the authors'hospital were selected as research objects, and they were divided into survival group (n=55) and death group (n=44) according to 7-day mortality. At the beginning of the CRRT, the Acute Physiology and Chronic Health Evaluation Ⅱscore (APACHE Ⅱscore), the Sequential Organ Failure Assessment score (SOFA score), the Simplified Acute Physiology Score 3 (SAPS3 score) and HELENICC score were evaluated in both groups, and the values of the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for APACHE Ⅱscore, SOFA score, SAPS3 score and HELENICC score were calculated.
Results In the death group, the mechanical ventilation time and length of hospital stay in ICU were significantly longer than those in the survival group (P < 0.01); in the death group, the dose of adrenaline, lactate level, creatinine level, ratio of cases with liver failure, medical condition, APACHE Ⅱscore, SOFA score, SAPS3 score and HELENICC score were significantly higher than those in the survival group (P < 0.05 or P < 0.01). With the increasing of the HELENICC score, the mortality increased gradually, and there was a linear correlation between the HELENICC score grade and the mortality (OR=3.17, 95%CI, 0.46 to 0.67, P < 0.05). The AUC was 0.729 for APACHE Ⅱscore (95%CI, 0.630 to 0.827, P < 0.01), 0.638 for SOFA score (95%CI, 0.521 to 0.754, P=0.019), 0.819 for SAPS3 score (95%CI, 0.737 to 0.901, P < 0.01), and 0.828 for HELENICC score (95%CI, 0.743 to 0.914, P < 0.01).
Conclusion HELENICC score can well predict the early mortality of S-AKI patients with CRRT in the ICU.