Comparison of comorbidities between the differing populations of patients: those who died in the first admission, those who survived and were readmitted and those who survived and werenât readmitted. (DOCX 15Â kb

Charles Ferro (512921)

David Rosser (4530109)

Jamie Coleman (103398)

Nerissa Jurawan (4530112)

Peter Nightingale (764487)

Simon Ball (345146)

Tanya Pankhurst (382059)

BMC Nephrology

Univariable and restricted multivariable analyses by Cox regression, for CRP effect on inpatient mortality, 90Â day mortality and mortality beyond 90Â days. (DOCX 33Â kb

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Additional file 11: of Hospital acquired Acute Kidney Injury is associated with increased mortality but not increased readmission rates in a UK acute hospital

Abstract Background Acute Kidney Injury (AKI) has evoked much interest over the past decade and is reported to be associated with high inpatient mortality. Preventable death and increased readmission rates related to AKI have been the focus of considerable interest. Methods We studied hospital acquired AKI in all emergency hospital admissions, except transfers from ICU to ICU or patients known to renal services, to ascertain mortality and readmission rates, and trackable modifiable factors for death, using cox regression and Kaplan Meier survival curves. Data was extracted from the electronic patient records and a series of case notes reviewed. Admissions were included between April 2006 and March 2010 (and patients followed up until September 2011). Results Overall incidence of AKI was 2.2%, (AKI stage 1, 61%, stage 2,27% and stage 3, 12%). In patients who sustain in-hospital AKI, 34% die in hospital, 42% are dead at 90 days and 48% at 1 year post discharge, compared to 12% 1 year mortality in patients without AKI. In multivariable analyses, AKI is an independent risk factor for in-hospital mortality (Hazard Ratio 1.6: 95% confidence intervals 1.43–1.75: P < 0.001), death within 90 days of discharge (Hazard Ratio 1.5: 95% confidence intervals 1.3–1.9: P < 0.001) and subsequent mortality beyond 90 days (Hazard Ratio 2.9: 95% confidence intervals 2.7–3.1: P < 0.001) after adjustment for co-morbidities and peak C-reactive protein. Thirty percent of the patients who died in the first 90 days post discharge and had AKI, also had malignancy. Readmission rates at 30 and 90 days were not increased by AKI after adjustment for co-morbidities and peak C-reactive protein. Conclusions A significant proportion of deaths in the first 90 days post-discharge may not be avoidable, due to malignancy and other end-stage disease. Readmission rates were not higher in patients who had had AKI

Nerissa Jurawan

Tanya Pankhurst

Charles Ferro

Peter Nightingale

Jamie Coleman

David Rosser

Simon Ball

Directory of Open Access Journals

Hospital acquired Acute Kidney Injury is associated with increased mortality but not increased readmission rates in a UK acute hospital

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BACKGROUND: Acute Kidney Injury (AKI) has evoked much interest over the past decade and is reported to be associated with high inpatient mortality. Preventable death and increased readmission rates related to AKI have been the focus of considerable interest.METHODS: We studied hospital acquired AKI in all emergency hospital admissions, except transfers from ICU to ICU or patients known to renal services, to ascertain mortality and readmission rates, and trackable modifiable factors for death, using cox regression and Kaplan Meier survival curves. Data was extracted from the electronic patient records and a series of case notes reviewed. Admissions were included between April 2006 and March 2010 (and patients followed up until September 2011).RESULTS: Overall incidence of AKI was 2.2%, (AKI stage 1, 61%, stage 2,27% and stage 3, 12%). In patients who sustain in-hospital AKI, 34% die in hospital, 42% are dead at 90 days and 48% at 1 year post discharge, compared to 12% 1 year mortality in patients without AKI. In multivariable analyses, AKI is an independent risk factor for in-hospital mortality (Hazard Ratio 1.6: 95% confidence intervals 1.43-1.75: P &lt; 0.001), death within 90 days of discharge (Hazard Ratio 1.5: 95% confidence intervals 1.3-1.9: P &lt; 0.001) and subsequent mortality beyond 90 days (Hazard Ratio 2.9: 95% confidence intervals 2.7-3.1: P &lt; 0.001) after adjustment for co-morbidities and peak C-reactive protein. Thirty percent of the patients who died in the first 90 days post discharge and had AKI, also had malignancy. Readmission rates at 30 and 90 days were not increased by AKI after adjustment for co-morbidities and peak C-reactive protein.CONCLUSIONS: A significant proportion of deaths in the first 90 days post-discharge may not be avoidable, due to malignancy and other end-stage disease. Readmission rates were not higher in patients who had had AKI.</p

Jurawan, Nerissa

Pankhurst, Tanya

Ferro, Charles

Nightingale, Peter

Coleman, Jamie

Rosser, David

Ball, Simon

University of Birmingham Research Portal