Validation of the Augmented Renal Clearance in Trauma Intensive Care scoring system for augmented renal clearance prediction in a trauma subgroup of a mixed ICU population.

Publisher: Country of Publication: England NLM ID: 8704308 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2710 (Electronic) Linking ISSN: 02694727 NLM ISO Abbreviation: J Clin Pharm Ther Subsets: MEDLINE

Publication: Oxford : Wiley-Blackwell Pub.
Original Publication: Oxford : Blackwell Scientific Publications, c1987-

Critical Care* ; Critical Illness*; Creatinine ; Humans ; Intensive Care Units ; Kidney Function Tests/methods ; Retrospective Studies

What Is Known and Objective: Augmented renal clearance is prevalent in trauma patients and leads to subtherapeutic levels of renally eliminated medications with potentially unfavourable clinical outcomes. The Augmented Renal Clearance of Trauma in Intensive Care (ARCTIC) score has been developed to predict augmented renal clearance in critically ill trauma patients. Our primary objective was to validate this score among the trauma subgroup of a mixed intensive care patient cohort.
Methods: This single-centre, retrospective, observational cohort study assessed augmented renal clearance using a timed 24-h urine collection performed weekly. ARC was defined as a measured creatinine clearance of ≥130 ml/min/1.73 m ² . ARCTIC score performance was evaluated through a receiver operator characteristic curves and analysis of sensitivities and specificities for the trauma subgroup, the medical/surgical subgroup and the pooled cohort.
Results and Discussion: Augmented renal clearance was observed in 33.9% (n = 58) of trauma patients (n = 171) and 15.7% (n = 24) of medical/surgical patients (n = 153). Examination of different cutoffs for the ARCTIC score in our trauma population confirmed that the optimal cutoff score was ≥6. Comparison between ROC curves for ARCTIC score and for regression model based upon our data in trauma patients indicated validation of the score in this subgroup. Comparison of sensitivities and specificities for ARCTIC score between trauma (93.1% and 41.6%, respectively) and medical/surgical subjects (87.5% and 49.6%, respectively) showed no clinical nor statistical difference, suggesting validation for the medical/surgical subgroup as well.
What Is New and Conclusion: In our mixed ICU population, the ARCTIC score was validated in the trauma subgroup. We also found that the score performed well in the medical/surgical population. Future studies should assess the performance of the ARCTIC score prospectively.
(© 2022 John Wiley & Sons Ltd.)

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Fonds de Recherche du Québec-Santé (FRQS); Faculty of Pharmacy of Université de Montréal; REDCap; Pharmacy Department of the MUHC

Keywords: ARCTIC score; augmented renal clearance; critically ill; score validation; trauma

AYI8EX34EU (Creatinine)

Date Created: 20220528 Date Completed: 20221006 Latest Revision: 20221006

20240829

10.1111/jcpt.13695

35633117