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Kidney Week

Abstract: FR-PO086

Outcomes of AKI among Hospitalized Patients with Infective Endocarditis

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Chandramohan, Deepak, The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Simhadri, Prathap, AdventHealth Daytona Beach, Daytona Beach, Florida, United States
  • Jena, Nihar K., Trinity Health Oakland Hospital, Pontiac, Michigan, United States
  • Avula, Sreekant, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Singh, Prabhat, Christus Spohn Hospital Corpus Christi Memorial, Corpus Christi, Texas, United States
  • Contractor, Renish, Florida State University, Tallahassee, Florida, United States
  • Filoramo, Michael R., Florida State University, Tallahassee, Florida, United States
  • Patel, Devansh H., The University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Lapsiwala, Boney Jayeshkumar, Government Medical College Surat, Surat, Gujarat, India
  • Chandramohan, Divya, The University of Texas at San Antonio, San Antonio, Texas, United States
Background

Patients with infective endocarditis (IE) are more susceptible to acute kidney injury (AKI). We aimed to assess the characteristics and outcomes of patients with AKI and IE.

Methods

The 2016-2020 National Inpatient Sample (NIS) database was utilized to include adult admissions with AKI and IE. A multivariable logistic regression was performed while adjusting for potential confounders to generate adjusted odds ratios for the outcomes of interest. The primary outcome was inpatient mortality. Secondary outcomes included length of stay (LOS), total hospital charges, septic shock, cardiogenic shock, vasopressor support, and requirement of mechanical ventilation.

Results

Of 63,725 admissions with IE, 16,295 (25.5%) had AKI. When compared with patients without AKI, patients with AKI were more likely to be male (63% vs. 57.6%, p<0.001), had higher Elixhauser Comorbidity Index >5 (73% vs. 44%, p<0.001), diabetes with complications (18.1% vs. 9.9%, p<0.001), congestive heart failure (50.5% vs. 28.1%, p<0.001), cardiac arrhythmias (45.5% vs. 31.6%, p<0.001) and chronic kidney disease (36.2% vs. 13.6%, p<0.001). They also had higher LOS of 17±16.1 days and mean hospital charges of 239046.8 ± 303977.3 $. Multivariable analysis showed higher odds of mortality (OR: 2.22, 95% CI: 1.81-2.73, p<0.001), septic shock (OR: 3.78, 95% CI: 2.97-4.82, p<0.001), cardiogenic shock (OR: 3.37, 95% CI: 2.65-4.28, p<0.001), vasopressor requirement (OR: 1.99, 95% CI: 1.52-2.60, p<0.001) and mechanical ventilation (OR: 2.75, 95% CI: 2.33-3.24, p<0.001).

Conclusion

Our analysis demonstrated that patients with AKI and infective endocarditis had adverse hospital outcomes, increased mortality, LOS, and hospital costs.