In-Hospital and 1-Year Mortality Trends in a National Cohort of US Veterans with Acute Kidney Injury. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Sohaney, Ryann; Yin, Huiying; Shahinian, Vahakn; Saran, Rajiv; Burrows, Nilka Ríos; Pavkov, Meda E.; Banerjee, Tanushree; Hsu, Chi-yuan; Powe, Neil; Steffick, Diane; Zivin, Kara; Heung, Michael
• Other Names: author non-byline.; Saran Rajiv author non-byline.; Shahinian Vahakn author non-byline.; Heung Michael author non-byline.; Gillespie Brenda author non-byline.; Morgenstern Hal author non-byline.; Herman William author non-byline.; Zivin Kara author non-byline.; Gipson Deb author non-byline.; Modi Zubin author non-byline.; Bragg-Gresham Jennifer author non-byline.; Steffick Diane author non-byline.; Han Yun author non-byline.; Zhang Xiaosong author non-byline.; Wyncott April author non-byline.; Powe Neil author non-byline.; Banerjee Tanushree author non-byline.; Tuot Delphine author non-byline.; Hsu Chi-yuan author non-byline.; Coresh Joe author non-byline.; McCulloch Charles author non-byline.; Crews Deidra author non-byline.; Burrows Nilka Ríos author non-byline.; Eberhardt Mark author non-byline.; Koyama Alain author non-byline.; Mondesire Juanita author non-byline.; Pavkov Meda E. author non-byline.; Rolka Deborah author non-byline.; Saydah Sharon author non-byline.
• Is Part Of: Clinical journal of the American Society of Nephrology. Volume 17:Issue 2(2022)
• Page Start: 184
• Page End: 193
• Publication Date: 2022-02
• Subjects: acute kidney injury -- mortality -- epidemiology and outcomes -- veterans -- cohort studies
• DOI: 10.2215/CJN.01730221
• Languages: English
• ISSNs: 1555-9041

Abstract

Visual Abstract: Abstract : Background and objectives: AKI, a frequent complication among hospitalized patients, confers excess short- and long-term mortality. We sought to determine trends in in-hospital and 1-year mortality associated with AKI as defined by Kidney Disease Improving Global Outcomes consensus criteria. Design, setting, participants, & measurements: This retrospective cohort study used data from the national Veterans Health Administration on all patients hospitalized from October 1, 2008 to September 31, 2017. AKI was defined by Kidney Disease Improving Global Outcomes serum creatinine criteria. In-hospital and 1-year mortality trends were analyzed in patients with and without AKI using Cox regression with year as a continuous variable. Results: We identified 1, 688, 457 patients and 2, 689, 093 hospitalizations across the study period. Among patients with AKI, 6% died in hospital, and 28% died within 1 year. In contrast, in-hospital and 1-year mortality rates were 0.8% and 14%, respectively, among non-AKI hospitalizations. During the study period, there was a slight decline in crude in-hospital AKI-associated mortality (hazard ratio, 0.98 per year; 95% confidence interval, 0.98 to 0.99) that was attenuated after accounting for patient demographics, comorbid conditions, and acute hospitalization characteristics (adjusted hazard ratio, 0.99 per year; 95% confidence interval, 0.99 to 1.00). This stable temporal trend in mortality persisted at 1 year (adjusted hazard ratio, 1.00 per year; 95% confidence interval, 0.99 to 1.00). Conclusions: AKI associated mortality remains high, as greater than one in four patients with AKI died within 1 year of hospitalization. Over the past decade, there seems to have been no significant progress toward improving in-hospital or long-term AKI survivorship.