The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database



Vincent, Jean-Louis, Ferguson, Andrew, Pickkers, Peter, Jakob, Stephan M, Jaschinski, Ulrich, Almekhlafi, Ghaleb A, Leone, Marc, Mokhtari, Majid, Fontes, Luis E, Bauer, Philippe R
et al (show 1 more authors) (2020) The clinical relevance of oliguria in the critically ill patient: analysis of a large observational database. CRITICAL CARE, 24 (1). 171-.

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Abstract

<h4>Background</h4>Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output < 0.5 ml/kg/h) in acutely ill patients and its association with the need for renal replacement therapy (RRT) and outcome.<h4>Methods</h4>International observational study. All adult (> 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis.<h4>Results</h4>Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient-oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged-oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent-oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103).<h4>Conclusions</h4>Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.

Item Type: Article
Uncontrolled Keywords: Urine output, Renal replacement therapy, Mortality
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 10 Feb 2022 08:38
Last Modified: 18 Jan 2023 21:12
DOI: 10.1186/s13054-020-02858-x
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3148628