Silver SA, et al. - This population-based study entailed the exploration of causes of death as well as patient and hospital factors associated with mortality after a hospitalization with AKI in residents in Ontario, Canada. Equally common incidence of both cancer-related death and cardiovascular death were reported in these patients, moreover, compared with the general population, substantially higher rates of occurrence of cancer-related deaths were documented in this population. These data indicate a need for strategies to care for and counsel patients with cancer who experience AKI.

Methods

• A population-based study was carried out in residents in Ontario, Canada, who survived a hospitalization with AKI from 2003 to 2013.
• Cause of death in the year after hospital discharge was classified as cardiovascular, cancer, infection-related, or other, using linked administrative databases.
• Researchers calculated standardized mortality ratios to compare the causes of death in survivors of AKI with those in the general adult population.
• They estimated determinants of death using Cox proportional hazards modeling.  

Results

• This study included a total of 156,690 patients, of those, death of 43,422 (28%) was reported in the subsequent year.
• Cardiovascular disease (28%) and cancer (28%) were reported as the most common causes of death, with respective standardized mortality ratios nearly 6-fold (5.81; 95% confidence interval [95% CI], 5.70 to 5.92) and 8-fold (7.87; 95% CI, 7.72 to 8.02) higher than those in the general population.
• Researchers found that the highest standardized mortality ratios were for bladder cancer (18.24; 95% CI, 17.10 to 19.41), gynecologic cancer (16.83; 95% CI, 15.63 to 18.07), and leukemia (14.99; 95% CI, 14.16 to 15.85).
• In addition, they noted that along with older age and nursing home residence, cancer and chemotherapy strongly associated with 1-year mortality.