Comparison of prognosis between hemodialysis patients with acute multiple organ failure and patients with acute multiple organ failure alone.

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• We compared the survival rate and APACHE II scores between a group of hemodialysis patients with acute multiple organ failure (acute-on-chronic cases) and a group of patients with acute multiple organ failure alone (acute cases). The subjects were 30 patients with severe sepsis or septic shock who received continuous hemodiafiltration (CHDF) at our institution between April 1996 and September 1997. Among them, 15 patients had acute-on-chronic cases and 15 patients had acute cases. The survival rates of the acute-on-chronic cases and the acute cases were 13% and 73%, respectively. We investigated the relationship between survival and the APACHE II score. The survival rate of acute-on-chronic cases was lower than that of acute cases, with the APACHE II scores being between 20-29 points and more than 30 points, respectively. The average APACHE II scores of acute-on-chronic deaths and acute deaths were 29.8±3.4 and 33.8±2.2, respectively. Therefore, we suggest that the chronic health score of hemodialysis patients should be increased from 5 points to 10 points. We also investigated the relationship of survival to the number of involved organs. When 3 organs were involved, the survival rate of acute-on-chronic cases was lower than that of acute cases. Therefore, we suggest that we should be aware of chronic renal failure in hemodialysis patients with 2 other organs involved. In conclusion, the prognosis of acute-on-chronic patients was worse than that of acute patients.

• 社団法人 日本透析医学会の論文

社団法人 日本透析医学会 | 論文

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