Alfredo De Giorgi1, Alda Storari2, Pedro Manuel Rodríguez-Muñoz3,4, Rosaria Cappadona5, Nicola Lamberti6, Fabio Manfredini6, Pablo Jesús López-Soto4,7,8, Roberto Manfredini5, Fabio Fabbian9. 1. Clinica Medica Unit, University Hospital of Ferrara, Ferrara, Italy. 2. Nephrology and Dialysis Unit, University Hospital of Ferrara, Ferrara, Italy. 3. Department of Nursing and Physiotherapy, Universidad de Salamanca, Salamanca, Spain. 4. Department of Nursing, Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain. 5. Department of Medical Science, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy. 6. Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy. 7. Department of Nursing, Universidad de Córdoba, Córdoba, Spain. 8. Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain. 9. Department of Medical Science, University of Ferrara, Via Luigi Borsari 46, 44121, Ferrara, Italy. f.fabbian@ospfe.it.
Abstract
PURPOSE: Acute kidney injury (AKI) frequently complicates hospitalization and is associated with in-hospital mortality (IHM). It has been reported a seasonal trend in different clinical conditions. The aim of this study was to evaluate the possible relationship between seasons of the year and IHM in elderly hospitalized patients with AKI. METHODS: We selected all admissions complicated by AKI between 2000 and 2015 recorded in the Italian National Hospital Database. ICD-9-CM code 584.xx identified subjects with age ≥ 65 years and age, sex, comorbidity burden, need of dialysis treatment and IHM were compared in hospitalizations recorded during the four seasons. Moreover, we plotted the AKI observed/expected ratio and percentage of mortality during the study period. RESULTS: We evaluated 759,720 AKI hospitalizations (mean age 80.5 ± 7.8 years, 52.2% males). Patients hospitalized with AKI during winter months had higher age, prevalence of dialysis-dependent AKI, and number of deceased patients. In whole population IHM was higher in winter and lower in summer, while the AKI observed/expected ratio demonstrated two peaks, one in summer and one in winter. Logistic regression analysis demonstrated that parameters such as age, autumn, winter, comorbidity burden were positively associated with IHM. CONCLUSION: We conclude that a seasonality exists in AKI, however, relationship between seasons and AKI could vary depending on the aspects considered. Both autumn and winter months are independent risk factors for IHM in patients with AKI regardless of age, sex and comorbidity burden. On the contrary, summer time reduces the risk of death during hospitalizations with AKI.
PURPOSE: Acute kidney injury (AKI) frequently complicates hospitalization and is associated with in-hospital mortality (IHM). It has been reported a seasonal trend in different clinical conditions. The aim of this study was to evaluate the possible relationship between seasons of the year and IHM in elderly hospitalized patients with AKI. METHODS: We selected all admissions complicated by AKI between 2000 and 2015 recorded in the Italian National Hospital Database. ICD-9-CM code 584.xx identified subjects with age ≥ 65 years and age, sex, comorbidity burden, need of dialysis treatment and IHM were compared in hospitalizations recorded during the four seasons. Moreover, we plotted the AKI observed/expected ratio and percentage of mortality during the study period. RESULTS: We evaluated 759,720 AKI hospitalizations (mean age 80.5 ± 7.8 years, 52.2% males). Patients hospitalized with AKI during winter months had higher age, prevalence of dialysis-dependent AKI, and number of deceased patients. In whole population IHM was higher in winter and lower in summer, while the AKI observed/expected ratio demonstrated two peaks, one in summer and one in winter. Logistic regression analysis demonstrated that parameters such as age, autumn, winter, comorbidity burden were positively associated with IHM. CONCLUSION: We conclude that a seasonality exists in AKI, however, relationship between seasons and AKI could vary depending on the aspects considered. Both autumn and winter months are independent risk factors for IHM in patients with AKI regardless of age, sex and comorbidity burden. On the contrary, summer time reduces the risk of death during hospitalizations with AKI.
Authors: Josè Vitale; Roberto Manfredini; Massimo Gallerani; Nicola Mumoli; Kim A Eagle; Walter Ageno; Francesco Dentali Journal: Chronobiol Int Date: 2014-11-21 Impact factor: 2.877
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