National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation
BackgroundAtrial fibrillation (AF) is a common cause for hospitalization, but there are limited data regarding acute kidney injury requiring dialysis (AKI‐D) in AF hospitalizations. We aimed to assess temporal trends and outcomes in AF hospitalizations complicated by AKI‐D utilizing a nationally rep...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.004509 |
| _version_ | 1828878264377016320 |
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| author | Lili Chan Swati Mehta Kinsuk Chauhan Priti Poojary Sagar Patel Sumeet Pawar Achint Patel Ashish Correa Shanti Patel Pranav S. Garimella Narender Annapureddy Shiv Kumar Agarwal Umesh Gidwani Steven G. Coca Girish N. Nadkarni |
| author_facet | Lili Chan Swati Mehta Kinsuk Chauhan Priti Poojary Sagar Patel Sumeet Pawar Achint Patel Ashish Correa Shanti Patel Pranav S. Garimella Narender Annapureddy Shiv Kumar Agarwal Umesh Gidwani Steven G. Coca Girish N. Nadkarni |
| author_sort | Lili Chan |
| collection | DOAJ |
| description | BackgroundAtrial fibrillation (AF) is a common cause for hospitalization, but there are limited data regarding acute kidney injury requiring dialysis (AKI‐D) in AF hospitalizations. We aimed to assess temporal trends and outcomes in AF hospitalizations complicated by AKI‐D utilizing a nationally representative database. Methods and ResultsUtilizing the Nationwide Inpatient Sample, AF hospitalizations and AKI‐D were identified using diagnostic and procedure codes. Trends were analyzed overall and within subgroups and utilized multivariable logistic regression to generate adjusted odds ratios (aOR) for predictors and outcomes including mortality and adverse discharge. Between 2003 and 2012, 3751 (0.11%) of 3 497 677 AF hospitalizations were complicated by AKI‐D. The trend increased from 0.3/1000 hospitalizations in 2003 to 1.5/1000 hospitalizations in 2012, with higher increases in males and black patients. Temporal changes in demographics and comorbidities explained a substantial proportion but not the entire trend. Significant comorbidities associated with AKI‐D included mechanical ventilation (aOR 13.12; 95% CI 9.88‐17.43); sepsis (aOR 8.20; 95% CI 6.00‐11.20); and liver failure (aOR 3.72; 95% CI 2.92‐4.75). AKI‐D was associated with higher risk of in‐hospital mortality (aOR 3.54; 95% CI 2.81‐4.47) and adverse discharge (aOR 4.01; 95% CI 3.12‐5.17). Although percentage mortality within AKI‐D decreased over the decade, attributable risk percentage mortality remained stable. ConclusionsAF hospitalizations complicated by AKI‐D have quintupled over the last decade with differential increase by demographic groups. AKI‐D is associated with significant morbidity and mortality. Without effective AKI‐D therapies, focus should be on early risk stratification and prevention to avoid this devastating complication. |
| first_indexed | 2024-12-13T09:02:12Z |
| format | Article |
| id | doaj.art-c76a0da1634540538b932711d1ff1d68 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:02:12Z |
| publishDate | 2016-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c76a0da1634540538b932711d1ff1d682022-12-21T23:53:09ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-12-0151210.1161/JAHA.116.004509National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial FibrillationLili Chan0Swati Mehta1Kinsuk Chauhan2Priti Poojary3Sagar Patel4Sumeet Pawar5Achint Patel6Ashish Correa7Shanti Patel8Pranav S. Garimella9Narender Annapureddy10Shiv Kumar Agarwal11Umesh Gidwani12Steven G. Coca13Girish N. Nadkarni14Icahn School of Medicine at Mount Sinai, New York, NYIcahn School of Medicine at Mount Sinai, New York, NYIcahn School of Medicine at Mount Sinai, New York, NYIcahn School of Medicine at Mount Sinai, New York, NYRutgers New Jersey Medical School, Newark, NJBoston University School of Medicine, Boston, MAIcahn School of Medicine at Mount Sinai, New York, NYIcahn School of Medicine at Mount Sinai, New York, NYIcahn School of Medicine at Mount Sinai, New York, NYUC San Diego, San Diego, CAVanderbilt University School of Medicine, Nashville, TNUniversity of Arkansas Medical Center, Little Rock, ARIcahn School of Medicine at Mount Sinai, New York, NYIcahn School of Medicine at Mount Sinai, New York, NYIcahn School of Medicine at Mount Sinai, New York, NYBackgroundAtrial fibrillation (AF) is a common cause for hospitalization, but there are limited data regarding acute kidney injury requiring dialysis (AKI‐D) in AF hospitalizations. We aimed to assess temporal trends and outcomes in AF hospitalizations complicated by AKI‐D utilizing a nationally representative database. Methods and ResultsUtilizing the Nationwide Inpatient Sample, AF hospitalizations and AKI‐D were identified using diagnostic and procedure codes. Trends were analyzed overall and within subgroups and utilized multivariable logistic regression to generate adjusted odds ratios (aOR) for predictors and outcomes including mortality and adverse discharge. Between 2003 and 2012, 3751 (0.11%) of 3 497 677 AF hospitalizations were complicated by AKI‐D. The trend increased from 0.3/1000 hospitalizations in 2003 to 1.5/1000 hospitalizations in 2012, with higher increases in males and black patients. Temporal changes in demographics and comorbidities explained a substantial proportion but not the entire trend. Significant comorbidities associated with AKI‐D included mechanical ventilation (aOR 13.12; 95% CI 9.88‐17.43); sepsis (aOR 8.20; 95% CI 6.00‐11.20); and liver failure (aOR 3.72; 95% CI 2.92‐4.75). AKI‐D was associated with higher risk of in‐hospital mortality (aOR 3.54; 95% CI 2.81‐4.47) and adverse discharge (aOR 4.01; 95% CI 3.12‐5.17). Although percentage mortality within AKI‐D decreased over the decade, attributable risk percentage mortality remained stable. ConclusionsAF hospitalizations complicated by AKI‐D have quintupled over the last decade with differential increase by demographic groups. AKI‐D is associated with significant morbidity and mortality. Without effective AKI‐D therapies, focus should be on early risk stratification and prevention to avoid this devastating complication.https://www.ahajournals.org/doi/10.1161/JAHA.116.004509acute kidney injuryatrial fibrillationdialysismortality |
| spellingShingle | Lili Chan Swati Mehta Kinsuk Chauhan Priti Poojary Sagar Patel Sumeet Pawar Achint Patel Ashish Correa Shanti Patel Pranav S. Garimella Narender Annapureddy Shiv Kumar Agarwal Umesh Gidwani Steven G. Coca Girish N. Nadkarni National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute kidney injury atrial fibrillation dialysis mortality |
| title | National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation |
| title_full | National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation |
| title_fullStr | National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation |
| title_full_unstemmed | National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation |
| title_short | National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation |
| title_sort | national trends and impact of acute kidney injury requiring hemodialysis in hospitalizations with atrial fibrillation |
| topic | acute kidney injury atrial fibrillation dialysis mortality |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.004509 |
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