Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock

English version

Autoři: Saraschandra Vallabhajosyula ^aff001; Shannon M. Dunlay ^aff001; Gregory W. Barsness ^aff001; Saarwaani Vallabhajosyula ^aff001; Shashaank Vallabhajosyula ^aff002; Pranathi R. Sundaragiri ^aff004; Bernard J. Gersh ^aff001; Allan S. Jaffe ^aff001; Kianoush Kashani ^aff002
Působiště autorů: Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United states of America ^aff001; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, United states of America ^aff002; Department of Health Science Research, Mayo Clinic, Rochester, Minnesota, United states of America ^aff003; Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, United states of America ^aff004; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, United states of America ^aff005
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222894

Souhrn

Background

There are limited data on acute kidney injury (AKI) complicating acute myocardial infarction with cardiogenic shock (AMI-CS). This study sought to evaluate 15-year national prevalence, temporal trends and outcomes of AKI with no need for hemodialysis (AKI-ND) and requiring hemodialysis (AKI-D) following AMI-CS.

Methods

This was a retrospective cohort study from 2000–2014 from the National Inpatient Sample (20% stratified sample of all community hospitals in the United States). Adult patients (>18 years) admitted with a primary diagnosis of AMI and secondary diagnosis of CS were included. The primary outcome was in-hospital mortality in cohorts with no AKI, AKI-ND, and AKI-D. Secondary outcomes included predictors, resource utilization and disposition.

Results

During this 15-year period, 440,257 admissions for AMI-CS were included, with AKI in 155,610 (35.3%) and hemodialysis use in 14,950 (3.4%). Older age, black race, non-private insurance, higher comorbidity, organ failure, and use of cardiac and non-cardiac organ support were associated with the AKI development and hemodialysis use. There was a 2.6-fold higher adjusted risk of developing AKI in 2014 compared to 2000. Presence of AKI-ND and AKI-D was associated with a 1.3 and 1.7-fold higher adjusted risk of mortality. Compared to the cohort without AKI, AKI-ND and AKI-D were associated with longer length of stay (9±10, 12±13, and 18±19 days respectively; p<0.001) and higher hospitalization costs ($101,859±116,204, $159,804±190,766, and $265,875 ± 254,919 respectively; p<0.001).

Conclusion

AKI-ND and AKI-D are associated with higher in-hospital mortality and resource utilization in AMI-CS.

Klíčová slova:

Biology and life sciences – Research and analysis methods – Population biology – Anatomy – Medicine and health sciences – Population metrics – Death rates – Health care – Health care facilities – Hospitals – Diagnostic medicine – Imaging techniques – Cardiology – Diagnostic radiology – Radiology and imaging – Surgical and invasive medical procedures – Renal system – Kidneys – Cardiovascular medicine – Cardiovascular imaging – Angiography – Cardiovascular procedures – Angioplasty – Coronary angioplasty – Nephrology – Medical dialysis – Myocardial infarction – Cardiac arrest

Zdroje

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