Epidemiology, Trajectories and Outcomes of Acute Kidney Injury Among Hospitalized Patients: A Retrospective Multicenter Large Cohort Study
arxiv(2024)
摘要
Background: Acute kidney injury (AKI) is a clinical syndrome affecting almost
one fifth of hospitalized patients, as well as more than half of the patients
who are admitted to the intensive care unit (ICU). Stratifying AKI patients
into groups based on severity and duration would facilitate more targeted
efforts for treating AKI. Methods: In a retrospective, multicenter and
longitudinal cohort study of 935,679 patients who were admitted between 2012
and 2020 to health centers included in OneFlorida+ Network, we analyzed the
impact of AKI trajectories which are rapidly reversed AKI, persistent AKI with
renal recovery, and persistent AKI without renal recovery on patients' clinical
outcomes, including hospital, 30-day, 1-year, and 3-year mortality, kidney
replacement therapy, new chronic kidney disease (CKD) within 90 days or 1-year
of discharge, CKD progression within 1-year of discharge, resource utilization,
hospital disposition, and major complications during hospitalization. As
analytical approaches, Kaplan-Meier estimators and survival curves, Cox
proportional-hazards regression model, logistic regression model,
Kruskal-Wallis test, analysis of variance, chi-square, Fisher's exact test were
used. Results: Among 2,187,254 encounters, 14
16
patients with persistent AKI was 31
outcomes and increased resource utilization compared to patients without the
condition. One-year mortality was 5 times greater for patients with persistent
AKI compared to those without AKI. Conclusions: Persistent AKI was associated
with prolonged hospitalization, increased ICU admission and mortality compared
to the other groups. This may emphasize the critical need for devising
strategies targeting effective management of AKI and prevention of persisting
AKI.
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