Identification of an optimal threshold to define oliguria in critically ill patients: an observational study
Authors' conclusion
The widely used cut-off for oliguria of 0.5 ml/kg/h over 6 h may be too conservative.
Study context
- Population
- Adults admitted to a multi-disciplinary ICU, January 1st 2010 to June 15th 2020, excluding chronic dialysis or declined consenttraining 12,440, validation 3110
- Participants
- 15,500 adults
- Exposure
- Oliguria thresholds of minimum average urinary output (UO) over 3, 6, 12 and 24 h vs consensus definition (UO < 0.5 ml/kg/h for 6 h)
- Outcome
- Optimal threshold of minimum average UO for oliguria, by relationship with 90-day mortality
- Follow-up
- 90 days
Methodological detailssingle-centre, training (80%) and validation (20%) sets
- Single-centre
- Training (80%) and validation (20%) sets
Main finding
As reported in the abstract
Inflexion point of minimum average UO vs predicted 90-day mortality
Nonlinear relationship; inflexion point for 3 and 6 h windows (ml/kg/h)
0.2
Inflexion point for 12 and 24 h windows (ml/kg/h)
0.3
Oliguria by consensus criteria (UO < 0.5 ml/kg/h for 6 h)
73.0% (95% CI [72.3-73.8])
Oliguria with threshold < 0.2 ml/kg/h over 6 h
24.7% (95% CI [24.0-25.4])
Observational data: associations, not effects.
Further findings
Model discrimination and calibration
- Excellent discrimination and calibration; AUC for all time windows
- > 85%
Original publication
Identification of an optimal threshold to define oliguria in critically ill patients: an observational study. Crit Care. Published 30 May 2023. doi:10.
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