Annika Ahlström

Publications (2)10.83 Total impact

• Article: Comparison of 2 acute renal failure severity scores to general scoring systems in the critically ill.

  Annika Ahlström, Anne Kuitunen, Seija Peltonen, Marja Hynninen, Minna Tallgren, Janne Aaltonen, Ville Pettilä
  [show abstract] [hide abstract]
  ABSTRACT: Several proposed definitions for acute renal failure (ARF) exist, but little is known of their significance in clinical practice. We evaluated the ability to predict hospital mortality in 2 ARF-specific severity-of-illness scoring methods, the Risk, Injury, Failure, Loss, End-Stage Renal Disease (RIFLE) score and the score presented by Bellomo et al in 2001. The study included 668 consecutive patients with 694 treatment episodes treated in 2 intensive care units (ICUs) in a university hospital within 11 months. ARF prevalence was classified according to the RIFLE and Bellomo scores. As references, we evaluated 2 general severity-of-illness scoring systems, the admission Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores. Admission SOFA scores and maximum RIFLE scores for the first 3 days in the ICU were independent predictors of hospital mortality by means of forward conditional logistic regression. In receiver operating characteristic analysis, SOFA and APACHE II scores performed better than ARF-specific scores, and discriminative powers for hospital mortality were only moderate for the RIFLE and Bellomo scores: areas under the curve were 0.653 (95% confidence interval, 0.588 to 0.719) and 0.587 (95% confidence interval, 0.514 to 0.660), respectively. Neither of the ARF-specific scoring methods presented good discriminative power regarding hospital mortality. However, maximum RIFLE score for the first 3 days in the ICU was found to be an independent predictor of hospital mortality, along with admission SOFA score.
  American Journal of Kidney Diseases 09/2006; 48(2):262-8. · 5.43 Impact Factor
• Article: Survival and quality of life of patients requiring acute renal replacement therapy.

  Annika Ahlström, Minna Tallgren, Seija Peltonen, Pirjo Räsänen, Ville Pettilä
  [show abstract] [hide abstract]
  ABSTRACT: To assess long-term survival and health-related quality of life in patients with acute renal failure. Cross-sectional cohort study in the ten-bed medical-surgical intensive care unit and the three-bed acute dialysis unit in a tertiary care hospital. 703 patients receiving renal replacement therapy for acute renal failure during 1998-2002. The mortality rate was 41% at 28 days, 57% at 1 year, and 70% at 5 years. SOFA score, age, and continuous renal replacement therapy were independent predictors of 1-year mortality. The median follow-up time was 3.9 years for mortality and 2.4 years for health-related quality of life. Of the 229 survivors in 2003, 153 (67%) responded to the health-related quality of life questionnaire. Health-related quality of life was evaluated with the EuroQol (EQ-5D) instrument including a visual analogue scale (VAS) score to evaluate the patient's perceived health. The EQ-5D score was significantly lower in the study population than in the age- and gender-matched Finnish population (0.68 vs. 0.86). Median VAS scores were 69.5 and 70.0, respectively. Patients' age and duration of follow-up had no significant effect on EQ-5D or VAS scores. Mortality and EQ-5D data were used to calculate quality-adjusted life years. Quality-adjusted survival was poor (15 quality-adjusted life years per 100 patients in the first year of follow-up). The long-term survival of patients with acute renal failure is poor. Although survivors have a low health-related quality of life, they are as satisfied with their health as the general population.
  Intensive Care Medicine 10/2005; 31(9):1222-8. · 5.40 Impact Factor