Ashish Correa1, Achint Patel2, Kinsuk Chauhan2, Harshil Shah3, Aparna Saha2, Mihir Dave2, Priti Poojary2, Abhishek Mishra4, Narender Annapureddy5, Shaman Dalal6, Ioannis Konstantinidis7, Renu Nimma8, Shiv Kumar Agarwal9, Lili Chan2, Girish Nadkarni2, Sean Pinney10. 1. Department of Medicine, Mount Sinai St. Luke's-West Hospital/Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: ashish.correa@mountsinai.org. 2. Department of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York. 3. Department of Medicine, Guthrie/Robert Packer Hospital, Sayre, Pennsylvania. 4. Department of Cardiology, Guthrie/Robert Packer Hospital, Sayre, Pennsylvania. 5. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. 6. University of Florida Center for HIV/AIDS Research, Education and Service, Department of Medicine, University of Florida College of Medicine, Jacksonville, Florida. 7. Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. 8. Department of Medicine, HackensackUMC Palisades, North Bergen, New Jersey. 9. Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas. 10. Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Abstract
BACKGROUND: Dialysis-requiring acute kidney injury (D-AKI) is a serious complication in hospitalized heart failure (HF) patients. However, data on national trends are lacking after 2002. METHODS: We used the Nationwide Inpatient Sample (2002-2013) to identify HF hospitalizations with and without D-AKI. We analyzed trends in incidence, in-hospital mortality, length of stay (LoS), and cost. We calculated adjusted odds ratios (aORs) for predictors of D-AKI and for outcomes including in-hospital mortality and adverse discharge (discharge to skilled nursing facilities, nursing homes, etc). RESULTS: We identified 11,205,743 HF hospitalizations. Across 2002-2013, the incidence of D-AKI doubled from 0.51% to 1.09%. We found male sex, younger age, African-American and Hispanic race, and various comorbidities and procedures, such as sepsis and mechanical ventilation, to be independent predictors of D-AKI in HF hospitalizations. D-AKI was associated with higher odds of in-hospital mortality (aOR 2.49, 95% confidence interval [CI] 2.36-2.63; P < .01) and adverse discharge (aOR 2.04, 95% CI 1.95-2.13; P < .01). In-hospital mortality and attributable risk of mortality due to D-AKI decreased across 2002-2013. LoS and cost also decreased across this period. CONCLUSIONS: The incidence of D-AKI in HF hospitalizations doubled across 2002-2013. Despite declining in-hospital mortality, LoS, and cost, D-AKI was associated with worse outcomes.
BACKGROUND: Dialysis-requiring acute kidney injury (D-AKI) is a serious complication in hospitalized heart failure (HF) patients. However, data on national trends are lacking after 2002. METHODS: We used the Nationwide Inpatient Sample (2002-2013) to identify HF hospitalizations with and without D-AKI. We analyzed trends in incidence, in-hospital mortality, length of stay (LoS), and cost. We calculated adjusted odds ratios (aORs) for predictors of D-AKI and for outcomes including in-hospital mortality and adverse discharge (discharge to skilled nursing facilities, nursing homes, etc). RESULTS: We identified 11,205,743 HF hospitalizations. Across 2002-2013, the incidence of D-AKI doubled from 0.51% to 1.09%. We found male sex, younger age, African-American and Hispanic race, and various comorbidities and procedures, such as sepsis and mechanical ventilation, to be independent predictors of D-AKI in HF hospitalizations. D-AKI was associated with higher odds of in-hospital mortality (aOR 2.49, 95% confidence interval [CI] 2.36-2.63; P < .01) and adverse discharge (aOR 2.04, 95% CI 1.95-2.13; P < .01). In-hospital mortality and attributable risk of mortality due to D-AKI decreased across 2002-2013. LoS and cost also decreased across this period. CONCLUSIONS: The incidence of D-AKI in HF hospitalizations doubled across 2002-2013. Despite declining in-hospital mortality, LoS, and cost, D-AKI was associated with worse outcomes.
Authors: Saraschandra Vallabhajosyula; Shannon M Dunlay; Gregory W Barsness; Saarwaani Vallabhajosyula; Shashaank Vallabhajosyula; Pranathi R Sundaragiri; Bernard J Gersh; Allan S Jaffe; Kianoush Kashani Journal: PLoS One Date: 2019-09-18 Impact factor: 3.240
Authors: Charalampos Loutradis; Luke Pickup; Jonathan P Law; Indranil Dasgupta; Jonathan N Townend; Paul Cockwell; Adnan Sharif; Pantelis Sarafidis; Charles J Ferro Journal: Biol Sex Differ Date: 2021-04-08 Impact factor: 5.027