The VExUS score and mortality in patients with Acute Kidney Injury: findings from a multidisciplinary prospective study

Abstract

Aim: The utility of the venous excess ultrasound (VExUS) score in predicting mortality remains uncertain in acute kidney injury (AKI) patients.

Material and methods: This was a post-hoc study involving 246 AKI patients presenting to a tertiary care emergency department. Venous ultrasound assessments were conducted to determine the VExUS score. Cox regression
analysis was used to identify predictors of 6-month mortality.

Results: The study found no significant association between the VExUS score and 6-month mortality in AKI patients in the regression analyses. However, in the subgroup analyses, VExUS grades 2-3 were associated with lower survival rates in the cardiorenal subgroup (HR: 3.98 [95% CI: 1.33–11.93]), and in AKI grade 1 (HR: 4.07 [95% CI: 1.74–9.49]). This association was not present in other AKI subgroups. The predictors of mortality included higher age (OR: 1.024; 95% CI 1.005-1.043), malignancy (OR: 2.186; 95% CI 1.408-3.392), lower systolic blood pressure (OR: 0.990; 95% CI 0.982-0.998), elevated pulse (OR: 1.013; 95% CI 1.005-1.022), and higher lactate levels (OR: 1.210; 95% CI 1.097-1.334).

Conclusion: The VExUS score did not predict 6-month mortality in the general cohort of AKI patients in the emergency department. However, VExUS grades 2-3 were associated with lower survival rates in the cardiorenal subgroup and patients with AKI grade 1.