Jurawan N, et al. - This study assessed the mortality and readmission rates in patients with hospital-acquired Acute Kidney Injury (AKI). Findings indicated that it may not be possible to avoid a significant proportion of deaths in the first 90 days post-discharge, due to malignancy and other end-stage disease. Furthermore, AKI patients did not have higher readmission rates.

Methods

• Excluding transfers from ICU to ICU or patients known to renal services, researchers studied hospital acquired AKI in all emergency hospital admissions in order to ascertain mortality and readmission rates, and trackable modifiable factors for death, using cox regression and Kaplan Meier survival curves.
• They derived data from the electronic patient records and reviewed a series of case notes as well.
• They also included admissions between April 2006 and March 2010 (and patients followed up until September 2011).

Results

• Data reported that overall incidence of AKI was 2.2%, (AKI stage 1, 61%, stage 2,27% and stage 3, 12%).
• According to findings, death was reported in the hospital, at 90 days post discharge and at 1 year post discharge in 34%, 42% and 48%, respectively, among patients who sustained in-hospital AKI, compared to 12% 1 year mortality in patients without AKI.
• After adjustment for co-morbidities and peak C-reactive protein in multivariable analyses, AKI independently conferred risk for in-hospital mortality (Hazard Ratio 1.6: 95% confidence intervals 1.43–1.75: P < 0.001), death within 90 days of discharge (Hazard Ratio 1.5: 95% confidence intervals 1.3–1.9: P < 0.001) and subsequent mortality beyond 90 days (Hazard Ratio 2.9: 95% confidence intervals 2.7–3.1: P < 0.001).
• Researchers detected malignancy in 30 % of the patients who died in the first 90 days post discharge and had AKI.
• In addition, they noted that after adjusting for co-morbidities and peak C-reactive protein, readmission rates at 30 and 90 days were not increased by AKI.