Nursing Activities Score and Acute Kidney Injury

Coelho, Filipe Utuari de Andrade; Watanabe, Mirian; Fonseca, Cassiane Dezoti da; Padilha, Katia Grillo; Vattimo, Maria de Fátima Fernandes

doi:10.1590/0034-7167-2016-0266

Brasil

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RESEARCH • Rev. Bras. Enferm. 70 (3) • May-Jun 2017 • https://doi.org/10.1590/0034-7167-2016-0266 linkcopy

Nursing Activities Score and Acute Kidney Injury

Nursing Activities Score y lesión renal aguda

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI).

Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively.

Results: A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001).

Conclusion: The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3.

Descriptors: Workload; Intensive Care Unit; Acute Renal Injury; Nursing; Nephrology

Characteristics	Total (N=190)					p value^* * p - comparison between patients with and without AKI;
	Without AKI (n=106)		With AKI (n=84)
	n	(%)	n	(%)
Sex	Male	49	46.2%	55	65.5%	0.008^ Chi-square test;
Sex	Female	57	53.8%	29	34.5%	0.008^ Chi-square test;
Type of hospitalization	Clinical	53	50%	61	72.6%	<0.001^ Chi-square test;
Type of hospitalization	Surgical	53	50%	23	27.4%
Clinical history	SAH	49	46.2%	48	57.1%	0.135^ Chi-square test;
	DM	30	28.3%	30	35.7%	0.343^ Chi-square test;
	COPD	4	3.7%	10	11.9%	0.033^ Chi-square test;
	HF	6	5.6%	15	17.8%	0.008^ Chi-square test;
ICU support	VAD	16	15%	37	44%	<0.001^ Chi-square test;
	MV	20	18.8%	50	59.5%	<0.001^ Chi-square test;
	RRT	0	0	14	16.7%	<0.001^ Chi-square test;
Outcome	Death	8	7.5%	28	33.3%	<0.001^ Chi-square test;
	Alive	97	91.5%	55	65.6%
	Transfer	1	1%	1	1.1%
		Mean	SD	Mean	SD
Age		58.8	18.1	64.7	16.9	0.026^* ***** Wilcoxon-Mann-Whitney test.
Length of stay		4.7	5.8	12.8	21.5	0.001^* ***** Wilcoxon-Mann-Whitney test.
MV time		2.4	13.3	4.7	14.0	0.245^* ***** Wilcoxon-Mann-Whitney test.
NAS		40.7	4.2	43.7	4.5	<0.001^* ***** Wilcoxon-Mann-Whitney test.
SAPS II		35.4	12.7	46.9	14.9	<0.001^* ***** Wilcoxon-Mann-Whitney test.

	Total (N=190)	NAS		p value^* * Tukey test.
	n	Mean	SD	Without LRA	AKI Stage 1	AKI Stage 2
Without AKI	108	40.7	4.2	-	-	-
AKI Stage 1	34	42.2	4.0	0.284^* * Tukey test.	-	-
AKI Stage 2	35	43.5	3.9	0.002^* * Tukey test.	0.483^* * Tukey test.	-
AKI Stage 3	15	45.9	5.1	*<0.001^ * Tukey test.**	0.002^* * Tukey test.	0.055^* * Tukey test.

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Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
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[TFN1] Note: AKI - acute kidney injury; SAH - systemic arterial hypertension; DM - diabetes mellitus; COPD - chronic obstructive pulmonary disease; HF - heart failure; ICU - intensive care unit; VAD - vasoactive drug; RRT - renal replacement therapy; MV - mechanical ventilation; NAS - Nursing Activities Score; SAPS II - Simplified Acute Physiology Score II; S.D - standard deviation;

[TFN2] ^*
p - comparison between patients with and without AKI;

[TFN3] ^**
Chi-square test;

[TFN4] ^***
Wilcoxon-Mann-Whitney test.