Ahmad Khan1, Khadija Sami2, Adnan Malik3, Muhammad Mujtaba Bhinder4, Khadija Naseem5, Kamesh Gupta6, Arsalan Siddiqui7, Emad Mansoor8, Shailendra Singh9, Khalid Mumtaz10. 1. Department of Medicine, West Virginia University Health Sciences Center Charleston Division, Charleston, West Virginia, USA. 2. Department of Medicine, Services Hospital, Lahore, Pakistan. 3. Department of Medicine, Floyd Medical Center, Rome, Georgia, USA. 4. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan. 5. Department of Medicine, West Virginia University Health Sciences Center Charleston Division, Charleston, West Virginia. 6. Department of Medicine, UMass Medical Center, Springfield, Massachusetts. 7. Division of Gastroenterology, Henry Ford Health System, Detroit, Michigan. 8. Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio. 9. Division of Gastroenterology, West Virginia University, Morgantown, West Virginia. 10. Division of Gastroenterology, Hepatology and Nutrition, Ohio State University, Wexner Medical Center, Columbus, Ohio, USA.
Abstract
BACKGROUND: Patients with acute hepatitis A virus (HAV) infection are at risk of developing acute kidney injury (AKI) which may result in increased healthcare resource utilization and worse clinical outcomes. We investigated the impact of AKI on healthcare utilization and clinical outcomes in patients hospitalized with acute HAV infection utilizing a large database. METHODS: We queried the National Inpatient Sample (NIS) 2007-2014 to identify acute HAV infection-related hospitalizations with and without AKI. Primary outcomes were prevalence of AKI and its predictors with secondary outcomes included the mean length of stay (LOS), hospitalization cost and mortality in both groups. RESULTS: Out of 68 364 acute HAV infection-related hospitalizations, 47 620 met our study criteria and 7458 (15.7%) had concurrent AKI. HAV patients with AKI were older (62.5 vs. 53.7 years; P value <0.001). A higher mean LOS (10.03 vs. 5.6 days; P value <0.001) and mean total hospitalization cost ($27 171.35 vs. $12 790.26; P value <0.001) were observed in HAV patients with the AKI group. A total of 1032 patients (13.8%) in the AKI group died during the same hospitalization as compared to 681 patients (1.5%) in the non-AKI group, P value <0.001. AKI in HAV was also found to be an independent predictor of mortality [adjusted odds ratio (aOR), 3.28; 95% confidence interval, 2.23-4.84; P value <0.001) after adjusting for the confounding factors. CONCLUSION: We found that 15.67% of patients hospitalized with acute HAV had AKI which contributed to increased healthcare utilization and higher mortality which is preventable.
BACKGROUND: Patients with acute hepatitis A virus (HAV) infection are at risk of developing acute kidney injury (AKI) which may result in increased healthcare resource utilization and worse clinical outcomes. We investigated the impact of AKI on healthcare utilization and clinical outcomes in patients hospitalized with acute HAV infection utilizing a large database. METHODS: We queried the National Inpatient Sample (NIS) 2007-2014 to identify acute HAV infection-related hospitalizations with and without AKI. Primary outcomes were prevalence of AKI and its predictors with secondary outcomes included the mean length of stay (LOS), hospitalization cost and mortality in both groups. RESULTS: Out of 68 364 acute HAV infection-related hospitalizations, 47 620 met our study criteria and 7458 (15.7%) had concurrent AKI. HAV patients with AKI were older (62.5 vs. 53.7 years; P value <0.001). A higher mean LOS (10.03 vs. 5.6 days; P value <0.001) and mean total hospitalization cost ($27 171.35 vs. $12 790.26; P value <0.001) were observed in HAV patients with the AKI group. A total of 1032 patients (13.8%) in the AKI group died during the same hospitalization as compared to 681 patients (1.5%) in the non-AKI group, P value <0.001. AKI in HAV was also found to be an independent predictor of mortality [adjusted odds ratio (aOR), 3.28; 95% confidence interval, 2.23-4.84; P value <0.001) after adjusting for the confounding factors. CONCLUSION: We found that 15.67% of patients hospitalized with acute HAV had AKI which contributed to increased healthcare utilization and higher mortality which is preventable.
Authors: H Tsubouchi; S Kawakami; S Hirono; H Miyazaki; M Kimoto; T Arima; K Sekiyama; M Yoshiba; N Arakaki; Y Daikuhara Journal: Lancet Date: 1992-08-01 Impact factor: 79.321
Authors: Su Hyun Kim; Hye Eun Yoon; Yong Kyun Kim; Jin Young Kim; Bum Soon Choi; Young Jin Choi; Young Ok Kim; Yong Soo Kim; Byung Kee Bang; Chul Woo Yang Journal: Nephron Clin Pract Date: 2008-07-25