The severity of initial acute kidney injury at admission of geriatric patients significantly correlates with subsequent in-hospital complications.
Acute kidney injury (AKI) is associated with higher hospital mortality. However, the relationship between geriatric AKI and in-hospital complications is unclear. We prospectively enrolled elderly patients (≥65 years) from general medical wards of National Taiwan University Hospital, part of whom presented AKI at admission. We recorded subsequent in-hospital complications, including catastrophic events, incident gastrointestinal bleeding, hospital-associated infections, and new-onset electrolyte imbalances. Regression analyses were utilized to assess the associations between in-hospital complications and the initial AKI severity. A total of 163 elderly were recruited, with 39% presenting AKI (stage 1: 52%, stage 2: 23%, stage 3: 25%). The incidence of any in-hospital complication was significantly higher in the AKI group than in the non-AKI group (91% vs. 68%, p < 0.01). Multiple regression analyses indicated that elderly patients presenting with AKI had significantly higher risk of developing any complication (Odds ratio [OR] = 3.51, p = 0.01) and new-onset electrolyte imbalance (OR = 7.1, p < 0.01), and a trend toward more hospital-associated infections (OR = 1.99, p = 0.08). The risk of developing complications increased with higher AKI stage. In summary, our results indicate that initial AKI at admission in geriatric patients significantly increased the risk of in-hospital complications.
Department of Medicine, National Taiwan University Hospital Jin-Shan branch, New Taipei City, Taiwan.|Graduate Institute of Toxicology, National Taiwan University Hospital, Taipei, Taiwan.
Chia-Ter
CT
Chao
Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Hung-Bin
HB
Tsai
The Department of Nursing, National Taiwan University, Taipei, Taiwan.
Chia-Yi
CY
Wu
Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Yu-Feng
YF
Lin
Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Nin-Chieh
NC
Hsu
Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Jin-Shing
JS
Chen
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Kuan-Yu
KY
Hung
D000137:Acid-Base Imbalance / Q000453:epidemiology / Q000209:etiology; D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D010343:Patient Admission; D063868:Patient Outcome Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology