Relationship of Serum Creatinine Level at Admission to an ICU for Cardiac Arrest with Subsequent Acute Kidney Injury

We investigated the association between the serum creatinine (SCr) level at admission to an intensive care unit (ICU) for cardiac arrest (CA) and subsequent acute kidney injury (AKI).

Data were from a previous study that was conducted at a single secondary care institute. Patients were included if they received successful cardiopulmonary resuscitation (CPR) after in-hospital CA (IHCA) or out-of-hospital CA (OHCA) and were admitted to an ICU. Patients were excluded if their SCr level at admission was missing or if they were younger than 18 years old. A total of 435 patients were screened for eligibility. 61 patients were excluded and the records of 374 patients who met the inclusion and exclusion criteria were examined.

Two multivariate models that adjusted for confounding factors showed that the SCr level at admission was independently associated with AKI in patients who received successful CPR. Receiver operating characteristic (ROC) analysis showed that an increased SCr level at admission was associated with subsequent AKI (area under the curve [AUC]: 0.823, 95% CI: 0.781, 0.865), and that the optimal SCr cutoff level was 1.15 mg/dL.

An increased SCr level at ICU admission for CA was independently associated with subsequent AKI without sex-related discrepancies, and the optimal cutoff level was 1.15 mg/dL.