Incidence and Cost of Acute Kidney Injury in Hospitalized Patients with Infective Endocarditis

Autor:	Katherine Donaldson, Mark Rudy, Dan Cleland, Gaixin Du, Javier A. Neyra, Alice Thornton, Victor Ortiz-Soriano, Moises A. Huaman, Joshua Lambert, Ye Li, Laura C. Fanucchi
Rok vydání:	2019
Předmět:	medicine.medical_specialty lcsh:Medicine 030204 cardiovascular system & hematology urologic and male genital diseases Article healthcare costs 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine Tricuspid valve opioid use infective endocarditis urogenital system business.industry Incidence (epidemiology) lcsh:R Acute kidney injury Retrospective cohort study General Medicine medicine.disease Comorbidity female genital diseases and pregnancy complications 3. Good health medicine.anatomical_structure acute kidney injury Infective endocarditis Complication business Kidney disease
Zdroj:	Journal of Clinical Medicine Journal of Clinical Medicine, Vol 8, Iss 7, p 927 (2019)
ISSN:	2077-0383
DOI:	10.3390/jcm8070927
Popis:	Acute kidney injury (AKI) is a frequent complication of hospitalized patients with infective endocarditis (IE). Further, AKI in the setting of IE is associated with high morbidity and mortality. We aimed to examine the incidence, clinical parameters, and hospital costs associated with AKI in hospitalized patients with IE in an endemic area with an increasing prevalence of opioid use. This retrospective cohort study included 269 patients admitted to a major referral center in Kentucky with a primary diagnosis of IE from January 2013 to December 2015. Of these, 178 (66.2%) patients had AKI by Kidney Disease Improving Global Outcomes (KDIGO) serum creatinine criteria: 74 (41.6%) had AKI stage 1 and 104 (58.4%) had AKI stage ≥2. In multivariable analysis, higher comorbidity scores and the need for diuretics were independently associated with AKI, while the involvement of the tricuspid valve and the need for vasopressor/inotrope support were independently associated with severe AKI (stage ≥2). The median total direct cost of hospitalization was progressively higher according to each stage of AKI ($17,069 for no AKI; $37,111 for AKI stage 1; and $61,357 for AKI stage ≥2; p < 0.001). In conclusion, two-thirds of patients admitted to the hospital due to IE had incident AKI. The occurrence of AKI significantly increased healthcare costs. The higher level of comorbidity, the affection of the tricuspid valve, and the need for diuretics and/or vasoactive drugs were associated with severe AKI in this susceptible population.
Databáze:	OpenAIRE
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