Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=28491339
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
The Clinical Epidemiology and 30-Day Outcomes of Emergency Department Patients
With Acute Kidney Injury
#MMPMID28491339
Scheuermeyer FX
; Grafstein E
; Rowe B
; Cheyne J
; Grunau B
; Bradford A
; Levin A
Can J Kidney Health Dis
2017[]; 4
(?): 2054358117703985
PMID28491339
show ga
BACKGROUND: Acute kidney injury (AKI) is associated with increased mortality and
dialysis in hospitalized patients but has been little explored in the emergency
department (ED) setting. OBJECTIVE: The objective of this study was to describe
the risk factors, prevalence, management, and outcomes in the ED population, and
to identify the proportion of AKI patients who were discharged home with no
renal-specific follow-up. DESIGN: This is a retrospective cohort study using
administrative and laboratory databases. SETTING: Two urban EDs in Vancouver,
British Columbia, Canada. PATIENTS: We included all unique ED patients over a
1-week period. METHODS: All patients had their described demographics,
comorbidities, medications, laboratory values, and ED treatments collected. AKI
was defined pragmatically, based upon accepted guidelines. The cohort was then
probabilistically linked to the provincial renal database to ascertain renal
replacement (transplant or dialysis) and the provincial vital statistics database
to obtain mortality. The primary outcome was the prevalence of AKI; secondary
outcomes included (1) the proportion of AKI patients who were discharged home
with no renal-specific follow-up and (2) the combined 30-day rate of death or
renal replacement among AKI patients. RESULTS: There were 1651 ED unique
patients, and 840 had at least one serum creatinine (SCr) obtained. Overall, 90
patients had AKI (10.7% of ED patients with at least one SCr, 95% confidence
interval [CI], 8.7%-13.1%; 5.5% of all ED patients, 95% CI, 4.4%-6.7%) with a
median age of 74 and 70% male. Of the 31 (34.4%) AKI patients discharged home, 4
(12.9%) had renal-specific follow-up arranged in the ED. Among the 90 AKI
patients, 11 died and none required renal replacement at 30 days, for a combined
outcome of 12.2% (95% CI, 6.5%-21.2%). LIMITATIONS: Sample sizes may be small.
Nearly half of ED patients did not obtain an SCr. Many patients did not have
sequential SCr testing, and a modified definition of AKI was used.
free
free
free
