title: Trends in acute kidney injury and outcomes after early percutaneous coronary intervention in patients ≥75 years of age with acute myocardial infarction.
abstract: We analyzed the Nationwide Inpatient Sample database from 2002 to 2010 to examine the temporal trends in incidence of acute kidney injury (AKI), AKI requiring dialysis, and associated in-hospital mortality in patients ≥75 years of age hospitalized with acute myocardial infarction and undergoing early (within 24 hours) percutaneous coronary intervention. Of 2,225,707 patients ≥75 years of age with acute myocardial infarction, 233,508 (10.5%) underwent early percutaneous coronary intervention, of which 21,961 (9.4%) developed AKI and 1,257 (0.54%) developed AKI requiring dialysis. From 2002 to 2010, the incidence of AKI increased from 5.6% to 14.2% (p for trend <0.001) and that for AKI requiring dialysis decreased (0.6% to 0.4%; p for trend 0.018). Compared with 2002, multivariable-adjusted odds ratios and 95% confidence intervals for AKI, AKI requiring dialysis, and in-hospital mortality in 2010 were 1.87 (1.71 to 2.05), 0.20 (0.15 to 0.27) and 0.74 (0.60 to 0.90), respectively. In conclusion, among hospitalized adults ≥75 years of age, from 2002 to 2010, there was an increase in AKI, but there was paradoxical decrease in AKI requiring dialysis and in-hospital mortality, potentially reflecting increased health-care provider awareness resulting in early recognition and implementation of renal-protective strategies and diagnosis-related group creep.
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, New York.
authors.forename: Sahil
authors.initials: S
authors.lastname: Khera
authors.forename: Dhaval
authors.initials: D
authors.lastname: Kolte
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Palaniswamy
authors.forename: Marjan
authors.initials: M
authors.lastname: Mujib
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
authors.forename: Savneek S
authors.initials: SS
authors.lastname: Chugh
authors.forename: Nivas
authors.initials: N
authors.lastname: Balasubramaniyam
authors.forename: Malik
authors.initials: M
authors.lastname: Edupuganti
authors.forename: William H
authors.initials: WH
authors.lastname: Frishman
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D003953:Diagnosis-Related Groups; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology