Critical Care

, 18:P368 | Cite as

Acute kidney injury of all severity is associated with extended hospitalization after critical illness

  • JR Prowle
  • I Kolic
  • J Purdell-Lewis
  • CJ Kirwan
Open Access
Poster presentation
  • 112 Downloads

Keywords

Emergency Medicine Retrospective Analysis Hospital Discharge Lower Probability Healthcare Cost 

Introduction

Acute kidney injury (AKI) complicates over 50% of ICU admissions and is associated with significantly increased mortality, length of stay, and costs across a broad spectrum of conditions [1].

Methods

We performed a single-centre, retrospective analysis of AKI diagnosis in patients with ICU admissions of 5 days or more who survived to hospital discharge between 2009 and 2011. We examined the relationship between hospital length of stay, AKI diagnosis, demographics and clinical characteristics in a multivariable Cox-hazard analysis.

Results

We identified 700 cases, with a 66% incidence of AKI. The AKI was associated with older age, greater initial illness severity and longer ICU and hospital length of stay in univariate analysis (Table 1). In Cox-hazard analysis, only AKI category and ICU length of stay were significantly associated with lower probability of discharge over time (Figure 1). AKI-1 was associated with a hazard ratio for hospital discharge of 0.66 (0.55 to 0.79), AKI-2 with 0.55 (0.42 to 0.71) and AKI-3 with 0.54 (0.44 to 0.66).
Table 1

Patient characteristics by AKI

 

No AKI

AKI

P value

Age

46 (32 to 60)

51 (37 to 64)

<0.001

SAPS-2

35 (27 to 42)

41 (32 to 49)

<0.001

ICU LOS

8 (6 to 12)

12 (7 to 18)

<0.001

Hospital LOS

27 (17 to 42)

41 (28 to 72)

<0.001

Data presented as median (IQR).

Figure 1

Cox-hazard prediction of AKI class on hospitalization (ICU LOS fixed at median).

Conclusion

AKI was a significant predictor of remaining in hospital at all levels of AKI severity even after allowing for longer ICU stay. Even mild AKI is associated with extended recovery from critical illness and healthcare costs even after ICU discharge.

References

  1. 1.
    Chertow , et al.: J Am Soc Nephrol. 2005, 11: 3365.CrossRefGoogle Scholar

Copyright information

© Prowle et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • JR Prowle
    • 1
  • I Kolic
    • 1
  • J Purdell-Lewis
    • 1
  • CJ Kirwan
    • 1
  1. 1.Barts Health NHS TrustLondonUK

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