Acute kidney injury predicts outcomes of non-critically ill patients.
OBJECTIVE
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.


METHODS
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.


RESULTS
Overall, patients with AKI had higher in-hospital mortality (14.8% vs 1.5%; P<.001), longer lengths of stay (median 7.9 vs 3.7 days; P<.001), and higher rates of transfer to critical care areas (28.6% vs 4.3%; P<.001); survivors were more likely to be discharged to an extended care facility (43.1% vs 20.3%; P<.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 (>or=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.


CONCLUSIONS
In this study, AKI was associated with adverse outcomes in non-critically ill patients.
Barrantes
Fidel
F
Bridgeport Hospital, Bridgeport, CT 06610, USA.
Feng
Yan
Y
Ivanov
Oleg
O
Yalamanchili
Hima B
HB
Patel
Janki
J
Buenafe
Xander
X
Cheng
Vicky
V
Dijeh
Sylvester
S
Amoateng-Adjepong
Yaw
Y
Manthous
Constantine A
CA
D058186:Acute Kidney Injury / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D017582:Renal Replacement Therapy; D012189:Retrospective Studies
D003404:Creatinine