Prognostic significance of low basal serum creatinine levels in internal intensive care unit patients

A. Sahin Tutak, H. Aydin, H.A. Findikli

Department of Internal Medicine, Medical Faculty, Adiyaman University, Adiyaman, Turkey. aysesahintutak@hotmail.com

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• Internal Medicine

OBJECTIVE: This study aimed to show the relationship between low creatinine level and mortality in the internal Intensive Care Unit (ICU) based on the view that there may be a relationship between low creatinine level and mortality in patients admitted to the ICU.

PATIENTS AND METHODS: This retrospective, single center study was performed in the ICU. Patients older than 18 years who stayed in the ICU for more than 24 hours were included in the study. Patients were evaluated for age, gender, albumin, creatinine levels and length of hospital stay in the analysis. Patients were divided into 7 groups according to serum creatinine levels: group 1: creatinine ≤ 0.4; group 2: 0.4 < creatinine ≤ 0.6; group 3: 0.6 < creatinine ≤ 0.8; group 4: 0.8 < creatinine ≤ 1.0; group 5: 1.0 < creatinine ≤ 1.2; group 6: 1.2 < creatinine ≤ 1.4; group 7: creatinine > 1.4 mg/dL. Creatinine level of 0.7-0.8 mg/dL was considered as reference and cox regression analysis was performed.

RESULTS: Of 2,359 patients admitted to the ICU, 699 died (29.6%). Mortality relationship according to the accepted creatinine levels of the patients showed a U-shaped distribution, and ICU mortality increased in both low and high creatinine levels. At low creatinine levels (creatinine ≤ 0.4 mg/dl), the mortality rate was 71.4% for men and 10.7% for female (p < 0.001). Cox regression analysis showed that group 1 and group 2 increased mortality (HR: 0.721, 95% CI; 0.555-0.936, HR: 0.509, 95% CI; 0.285-0.909, respectively).

CONCLUSIONS: In patients admitted to ICU, lower creatinine acceptance is associated with increased ICU mortality and reduced survival.

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