High death rates correlate with AKI in hospitalized veterans
Click Here to Manage Email Alerts
AKI-related hospitalizations correlated with high mortality rates among veterans, according to data published in the Clinical Journal of the American Society of Nephrology.
Further, between 2008 and 2017, one in four veterans with AKI died within 1 year of hospitalization.
“Previous studies have indicated that in-hospital mortality among patients with dialysis-requiring AKI has declined from 2000 to 2015,” Ryann E. Sohaney, DO, from the division of nephrology in the department of internal medicine at the University of Michigan, and colleagues wrote. They added, “Whether any potential mortality reduction persists beyond the initial hospitalization period is unknown. The goal of this study was to examine recent short- and long-term mortality trends in hospitalized patients with AKI as defined by the consensus criteria.”
In a retrospective cohort study, researchers evaluated data on all patients hospitalized between Oct. 1, 2008, and Sept. 31, 2017, from the national Veterans Health Administration. Using Cox proportional hazards models, researchers conducted time-to-event analyses to determine mortality trends in the AKI and non-AKI cohorts. Researchers considered two primary outcomes: all-cause in-hospital mortality and all-cause mortality 1 year following hospitalization.
During the study period, researchers determined there were 1,688,457 patients and 2,689,093 hospitalizations. Of the patients with AKI, 6% died in the hospital and 28% died within 1 year. Among patients with non-AKI-related hospitalizations, 0.8% died in the hospital and 14% died within 1 year. Between 2008 and 2017, researchers observed a slight decline in crude in-hospital AKI-related mortality that was reduced after noting patient demographics, comorbid conditions and acute hospitalization characteristics. For veterans hospitalized with AKI, the in-hospital and 1-year mortality rates stayed consistent throughout the study period.
“Our study indicates that AKI-associated mortality remains high, as greater than one in four patients died within 1 year. There has been no significant progress toward improving in-hospital or long-term AKI survivorship,” Sohaney said in a press release.
The limitations of the study included a high proportion of men, although approximately 28,000 women with AKI-related hospitalizations were identified.
In an editorial, Kianoush B. Kashani, MD, MS, from the division of nephrology and hypertension at the Mayo Clinic in Rochester, Minnesota wrote, “Further work is needed to determine more specifically the underlying reason for the observed improvement in AKI-related mortality in the hospital. Determining the specific practice or care processes that are most impactful on the observed improved kidney outcomes would be an essential target to consider for future clinical trials and quality improvement projects.”
References:
- Study reveals high death rates associated with acute kidney injury in hospitalized veterans. https://www.newswise.com/articles/study-reveals-high-death-rates-associated-with-acute-kidney-injury-in-hospitalized-veterans?sc=cwhr&xy=10007438/?ad2f=1&aid=764709. Published Feb. 7, 2022. Accessed Feb. 7, 2022.
- The Kidney: A Vital Organ. https://cjasn.asnjournals.org/content/17/2/179. Published Feb. 7, 2022. Accessed Feb. 7, 2022.
Collapse
Click Here to Manage Email Alerts