Özet:

Introduction: Acute kidney injury (AKI) is characterised by the sudden impairment in the kidney function resulting in retention of nitrogenous and other waste products and is associated with a high rate of mortality. One of the main problems of critically ill AKI patients is the lack of validated, well-established scoring systems to stratify the severity of patient disease states. The third generation ICU scoring systems i.e. SAPS 3 and APACHE IV are more updated. These models have been less assessed on non- dialysis acute kidney injury patients in ICU. The objective of this study is to compare between the two-scoring systems in predicting the outcome of patients with Acute kidney injury admitted in ICU. Methods: Sample size was calculated using the G* POWER 3.1 version software. Patients admitted in intensive care unit of Yenepoya Medical College Hospital with acute kidney injury were chosen for the study after informed consent. Detailed history was taken, and systemic examination was done. Relevant investigations were done which was required for the scoring. Data considered for the calculation of the SAPS 3 was collected and recorded within 1 hour of ICU admission and predicted mortality rates were calculated. APACHE IV scores were calculated using data during the first 24 hours of admission and predicted mortality rates were calculated as per the APACHE IV calculator by RNSH, Sydney. SPSS (Statistical Package for Social Sciences) version 20 [IBM SPSS statistics (IBM Corp., Armonk, NY, USA released 2011)] was used to perform the statistical analysis. Results: Out of total 75 AKI patients, 56(74.6%) patients survived, and 19(25.4%) patients died. Among these total 75 patients 46 patients were males and 29 patients were females. Most of the survivors were in the age group 56 to 65 years (33.9%). The sensitivity of both APACHE 4 and SAPS 3 scores were same at 78.9%, and specificity was higher for APACHE 4 score (67.9%) compared to 62.5% in SAPS 3. These changes were statistically significant.Conclusion: In this observational study conducted at intensive care unit in Yenepoya medical college, the collected data statistically demonstrates that APACHE IV score predicts mortality better than SAPS. However, the sensitivity of both scores remained similar, the specificity was higher for APACHE IV. SAPS 3 scoring system had the advantage of predicting the mortality rate prior to the ICU intervention.

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