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Fluid balance and mortality in critically ill patients with acute kidney injury: a multicenter prospective epidemiological study

Overview of attention for article published in Critical Care, October 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (93rd percentile)

Mentioned by

blogs
1 blog
twitter
83 tweeters
facebook
1 Facebook page
googleplus
1 Google+ user

Citations

dimensions_citation
109 Dimensions

Readers on

mendeley
148 Mendeley
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Title
Fluid balance and mortality in critically ill patients with acute kidney injury: a multicenter prospective epidemiological study
Published in
Critical Care, October 2015
DOI 10.1186/s13054-015-1085-4
Pubmed ID
Authors

Na Wang, Li Jiang, Bo Zhu, Ying Wen, Xiu-Ming Xi

Abstract

Early and aggressive volume resuscitation is fundamental in the treatment of hemodynamic instability in critically ill patients and improves patient survival. However, one important consequence of fluid administration is the risk of developing fluid overload (FO), which is associated with increased mortality in patients with acute kidney injury (AKI). We evaluated the impact of fluid balance on mortality in intensive care unit (ICU) patients with AKI. The data were extracted from the Beijing Acute Kidney Injury Trial. This trial was a prospective, observational, multicenter study conducted in 30 ICUs among 28 tertiary hospitals in Beijing, China, from 1 March to 31 August 2012. In total, 3107 patients were admitted consecutively, and 2526 patients were included in this study. The data from the first 3 sequential days were analyzed. The AKI severity was classified according to the Kidney Disease: Improving Global Outcomes guidelines. The daily fluid balance was recorded, and the cumulative fluid balance was registered at 24, 48, and 72 h. A multivariate analysis was performed with Cox regression to determine the impact of fluid balance on mortality in patients with AKI. Among the 2526 patients included, 1172 developed AKI during the first 3 days. The mortality was 25.7 % in the AKI group and 10.1 % in the non-AKI group (P < 0.001). The daily fluid balance was higher, and the cumulative fluid balance was significantly greater, in the AKI group than in the non-AKI group. FO was an independent risk factor for the incidence of AKI (odds ratio 4.508, 95 % confidence interval 2.900 to 7.008, P < 0.001) and increased the severity of AKI. Non-surviving patients with AKI had higher cumulative fluid balance during the first 3 days (2.77 [0.86-5.01] L versus 0.93 [-0.80 to 2.93] L, P < 0.001) than survivors did. Multivariate analysis revealed that the cumulative fluid balance during the first 3 days was an independent risk factor for 28-day mortality. In this multicenter ICU study, the fluid balance was greater in patients with AKI than in patients without AKI. FO was an independent risk factor for the incidence of AKI and increased the severity of AKI. A higher cumulative fluid balance was an important factor associated with 28-day mortality following AKI.

Twitter Demographics

The data shown below were collected from the profiles of 83 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 148 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Mexico 1 <1%
Colombia 1 <1%
Italy 1 <1%
Brazil 1 <1%
Unknown 144 97%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 20 14%
Other 20 14%
Student > Postgraduate 18 12%
Student > Master 15 10%
Researcher 13 9%
Other 44 30%
Unknown 18 12%
Readers by discipline Count As %
Medicine and Dentistry 103 70%
Nursing and Health Professions 8 5%
Engineering 2 1%
Agricultural and Biological Sciences 2 1%
Pharmacology, Toxicology and Pharmaceutical Science 2 1%
Other 10 7%
Unknown 21 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 59. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 May 2016.
All research outputs
#393,794
of 16,104,892 outputs
Outputs from Critical Care
#298
of 5,078 outputs
Outputs of similar age
#9,913
of 287,179 outputs
Outputs of similar age from Critical Care
#24
of 366 outputs
Altmetric has tracked 16,104,892 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,078 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.0. This one has done particularly well, scoring higher than 94% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 287,179 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 366 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 93% of its contemporaries.