Acute Kidney Injury Predicts Outcomes of Non-Critically Ill Patients

To evaluate whether acute kidney injury (AKI), defined as an increase in the serum creatinine level of 0.3 mg/dL or more within 48 hours, predicts outcomes of non-critically ill patients. Among the adults admitted from June 1, 2005, to June 30, 2007, to the medical wards of a community teaching hosp...

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Veröffentlicht in:Mayo Clinic proceedings 2009-05, Vol.84 (5), p.410-416
Hauptverfasser: Barrantes, Fidel, Feng, Yan, Ivanov, Oleg, Yalamanchili, Hima B., Patel, Janki, Buenafe, Xander, Cheng, Vicky, Dijeh, Sylvester, Amoateng-Adjepong, Yaw, Manthous, Constantine A.
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container_end_page 416
container_issue 5
container_start_page 410
container_title Mayo Clinic proceedings
container_volume 84
creator Barrantes, Fidel
Feng, Yan
Ivanov, Oleg
Yalamanchili, Hima B.
Patel, Janki
Buenafe, Xander
Cheng, Vicky
Dijeh, Sylvester
Amoateng-Adjepong, Yaw
Manthous, Constantine A.
description To evaluate whether acute kidney injury (AKI), defined as an increase in the serum creatinine level of 0.3 mg/dL or more within 48 hours, predicts outcomes of non-critically ill patients. Among the adults admitted from June 1, 2005, to June 30, 2007, to the medical wards of a community teaching hospital, 735 patients with AKI and 5089 controls were identified. Demographic and health information, serum creatinine values, and outcomes were abstracted from patients' computerized medical records. Outcomes of patients with AKI were compared with those of controls. In an additional case-control analysis, more detailed clinical information was abstracted from the medical records of 282 pairs of randomly selected, age-matched AKI cases and controls. Conditional multivariate logistic regression analyses were used to adjust for potential confounders of AKI effect on outcomes. Overall, patients with AKI had higher in-hospital mortality (14.8% vs 1.5%; P
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Among the adults admitted from June 1, 2005, to June 30, 2007, to the medical wards of a community teaching hospital, 735 patients with AKI and 5089 controls were identified. Demographic and health information, serum creatinine values, and outcomes were abstracted from patients' computerized medical records. Outcomes of patients with AKI were compared with those of controls. In an additional case-control analysis, more detailed clinical information was abstracted from the medical records of 282 pairs of randomly selected, age-matched AKI cases and controls. Conditional multivariate logistic regression analyses were used to adjust for potential confounders of AKI effect on outcomes. Overall, patients with AKI had higher in-hospital mortality (14.8% vs 1.5%; P&lt;.001), longer lengths of stay (median 7.9 vs 3.7 days; P&lt;.001), and higher rates of transfer to critical care areas (28.6% vs 4.3%; P&lt;.001); survivors were more likely to be discharged to an extended care facility (43.1% vs 20.3%; P&lt;.001). Conditional multivariate logistic regression analyses of the 282 pairs of cases and controls showed that patients with AKI were 8 times more likely to die in hospital (odds ratio [OR], 7.9; 95% CI [confidence interval], 2.9-15.3) and were 5 times more likely to have prolonged (≥7 days) hospital stays (OR, 5.2; 95% CI, 3.5-7.9) and require intensive care (OR, 4.7; 95% CI, 2.7-8.1), after adjustment for age, comorbidities, and other potential confounders. 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Urinary tract diseases ; Original ; Predictive Value of Tests ; Prognosis ; Renal Replacement Therapy ; Retrospective Studies ; Urinary system involvement in other diseases. 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Among the adults admitted from June 1, 2005, to June 30, 2007, to the medical wards of a community teaching hospital, 735 patients with AKI and 5089 controls were identified. Demographic and health information, serum creatinine values, and outcomes were abstracted from patients' computerized medical records. Outcomes of patients with AKI were compared with those of controls. In an additional case-control analysis, more detailed clinical information was abstracted from the medical records of 282 pairs of randomly selected, age-matched AKI cases and controls. Conditional multivariate logistic regression analyses were used to adjust for potential confounders of AKI effect on outcomes. Overall, patients with AKI had higher in-hospital mortality (14.8% vs 1.5%; P&lt;.001), longer lengths of stay (median 7.9 vs 3.7 days; P&lt;.001), and higher rates of transfer to critical care areas (28.6% vs 4.3%; P&lt;.001); survivors were more likely to be discharged to an extended care facility (43.1% vs 20.3%; P&lt;.001). Conditional multivariate logistic regression analyses of the 282 pairs of cases and controls showed that patients with AKI were 8 times more likely to die in hospital (odds ratio [OR], 7.9; 95% CI [confidence interval], 2.9-15.3) and were 5 times more likely to have prolonged (≥7 days) hospital stays (OR, 5.2; 95% CI, 3.5-7.9) and require intensive care (OR, 4.7; 95% CI, 2.7-8.1), after adjustment for age, comorbidities, and other potential confounders. In this study, AKI was associated with adverse outcomes in non-critically ill patients.</description><subject>Acute Kidney Injury - blood</subject><subject>Acute Kidney Injury - mortality</subject><subject>Acute Kidney Injury - physiopathology</subject><subject>Acute renal failure</subject><subject>Aged</subject><subject>Analysis and chemistry</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Care and treatment</subject><subject>Case-Control Studies</subject><subject>Chi-Square Distribution</subject><subject>Creatinine - blood</subject><subject>Diagnosis</subject><subject>Female</subject><subject>General aspects</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Kidneys</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Original</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Renal Replacement Therapy</subject><subject>Retrospective Studies</subject><subject>Urinary system involvement in other diseases. 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Urinary tract diseases</topic><topic>Original</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Renal Replacement Therapy</topic><topic>Retrospective Studies</topic><topic>Urinary system involvement in other diseases. 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Among the adults admitted from June 1, 2005, to June 30, 2007, to the medical wards of a community teaching hospital, 735 patients with AKI and 5089 controls were identified. Demographic and health information, serum creatinine values, and outcomes were abstracted from patients' computerized medical records. Outcomes of patients with AKI were compared with those of controls. In an additional case-control analysis, more detailed clinical information was abstracted from the medical records of 282 pairs of randomly selected, age-matched AKI cases and controls. Conditional multivariate logistic regression analyses were used to adjust for potential confounders of AKI effect on outcomes. 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In this study, AKI was associated with adverse outcomes in non-critically ill patients.</abstract><cop>Rochester, MN</cop><pub>Elsevier Inc</pub><pmid>19411437</pmid><doi>10.1016/S0025-6196(11)60559-4</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Acute Kidney Injury - blood
Acute Kidney Injury - mortality
Acute Kidney Injury - physiopathology
Acute renal failure
Aged
Analysis and chemistry
Biological and medical sciences
Blood
Care and treatment
Case-Control Studies
Chi-Square Distribution
Creatinine - blood
Diagnosis
Female
General aspects
Hospital Mortality
Humans
Kidneys
Length of Stay
Logistic Models
Male
Medical sciences
Nephrology. Urinary tract diseases
Original
Predictive Value of Tests
Prognosis
Renal Replacement Therapy
Retrospective Studies
Urinary system involvement in other diseases. Miscellaneous
title Acute Kidney Injury Predicts Outcomes of Non-Critically Ill Patients
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