Abstract: FR-PO087
Prognosis of Community-Acquired Kidney Injury in the Emergency Department
Session Information
- AKI: Diagnosis and Outcomes
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Ragnarsdóttir, Telma Huld, Landspitali, Reykjavik, Iceland
- Kristjansdottir, Margret, Landspitali, Reykjavik, Iceland
- Gislason, Gisli, Landspitali, Reykjavik, Iceland
- Palsson, Runolfur, Landspitali, Reykjavik, Iceland
- Indridason, Olafur S., Landspitali, Reykjavik, Iceland
Background
Acute kidney injury (AKI) is a common and serious complication of acute illness, significantly affecting outcomes. While the course and prognosis of hospital-acquired AKI has been thoroughly studied, the outcome of community-acquired AKI has not been well characterized. The aim of this study was to prospectively examine the outcome of patients with community-acquired AKI.
Methods
This was a prospective comparative cohort study in which serum creatinine (SCr) of all individuals presenting to the emergency department (ED) of Landspitali University Hospital were examined for the presence of AKI. All patients who met the SCr component of the KDIGO criteria for AKI were invited to participate. Randomly selected control cases (1:2) were paired according to age, sex, and date of ED admission. Participants answered questions about their medical history and use of medications. Past medical history was also obtained from medical records. Hospital admissions, re-admissions and survival rates were explored over a one-year follow-up period. Groups were compared using the χ2 test for categorical variables and t-test for continuous variables.
Results
During the study period, AKI was identified in 574 persons, 488 of whom participated in the study (512 cases). The mean (±SD) age of AKI cases and controls was 67.1±16.6 years and 67.2 ±16.2 years, respectively; 48% of cases and controls were female. AKI cases were significantly more likely than controls to be admitted to the hospital following the ED visit (77.1% vs 59.9%, p<0.001), and had longer hospital stays (8.0 ± 10.9 days vs 4.9 ± 15.4 days, p<0.001). Compared with the control group, in-hospital mortality was higher among AKI cases (6.3% vs. 2.4%, p<0.001), as was 90-day mortality (11.1% vs 4.9%, p<0.001) and one-year mortality (17.4% vs 11.2%, p<0.001). No significant difference in readmission rates within one month (14.9% vs 12.4%) or one year (40.8% vs 38.6%)- was observed.
Conclusion
Patients presenting to the ED with community-acquired AKI are significantly more likely to require hospitalization and experienced longer hospital stays, and higher mortality rates than those without AKI. However, the readmission rate is similar to controls.
Funding
- Government Support – Non-U.S.