Prediction of mortality in acute renal failure in the tropics.

Despite significant improvements in medical care, acute renal failure (ARF) remains a high risk for mortality. It is important to be able to predict the outcome in these patients in view of the emotional and ethical needs of the patients and to address questions of efficiency and quality of care. We analyzed the risk factors predicting mortality prospectively in a group of 265 patients using univariate and multiple logistic regression analysis. A prognostic model was evolved that included 10 variables. The model showed good discrimination [(receiver operating characteristic (ROC) area = 0.91) and correctly classified 88.30% of patients. The variables significantly associated with mortality were coma odds ratio (OR) = 9.8], oliguria (OR = 4.9), jaundice (OR = 3.7), hypotension (OR = 3.1), assisted ventilation (OR = 2.3), hospital acquired ARF (OR = 2.3), sepsis (OR = 2.2), and hypoalbuminemia (OR = 1.7). Age and male gender were included in the model as they are clinically important. The score was validate...