title: Association between in-hospital mortality and renal dysfunction in 186,219 patients hospitalized for acute stroke in the Emilia-Romagna region of Italy.
abstract: Using a regional Italian database, we evaluated the relationship between renal dysfunction and in-hospital mortality (IHM) in patients with acute stroke (ischemic/hemorrhagic). Patients were classified on the basis of renal damage: without renal dysfunction, with chronic kidney disease (CKD), and with end-stage renal disease (ESRD). Of a total of 186,219 patients with a first episode of stroke, 1626 (0.9%) had CKD and 819 (0.4%) had ESRD. Stroke-related IHM (total cases) was independently associated with CKD, ESRD, atrial fibrillation (AF), age, and Charlson comorbidity index (CCI). In patients with ischemic stroke (n=154,026), IHM remained independently associated with CKD, ESRD, AF, and CCI. In patients with hemorrhagic stroke (n=32,189), variables that were independently associated with IHM were CKD, ESRD, and AF. Renal dysfunction is associated with IHM related to stroke, both ischemic and hemorrhagic, with even higher odds ratios than those of other established risk factors, such as age, comorbidities, and AF.
authors.affiliation: Clinica Medica, Azienda Ospedaliera-Universitaria (AOU), Ferrara, Italy f.fabbian@ospfe.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Fabbian
authors.affiliation: 1st Unit of Internal Medicine, AOU, Ferrara, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Gallerani
authors.affiliation: Clinica Medica, Azienda Ospedaliera-Universitaria (AOU), Ferrara, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pala
authors.affiliation: Clinica Medica, Azienda Ospedaliera-Universitaria (AOU), Ferrara, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: De Giorgi
authors.affiliation: 2nd Unit of Internal Medicine, AOU, Ferrara, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Salmi
authors.affiliation: Department of Clinical Medicine, University of Insubria, Varese, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Dentali
authors.affiliation: Department of Clinical Medicine, University of Insubria, Varese, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ageno
authors.affiliation: Clinica Medica and Vascular Diseases Center, AOU, Ferrara, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredini
mesh_terms: D000368:Aged; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000401:mortality*; D007677:Kidney Function Tests; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*; D014057:Tomography, X-Ray Computed
keywords: ICD-9-CM; chronic kidney disease; comorbidity; end-stage renal disease; mortality; stroke