AI Article Synopsis

  • Scientists studied how often patients get a type of kidney injury called contrast-induced acute kidney injury (CI-AKI) when they have certain heart procedures in hospitals.
  • They looked at a lot of hospital records from France over two years and found that about 3.1% of those patients developed suspected CI-AKI.
  • Factors like heart failure and having existing kidney problems made it more likely for patients to get this injury, and those who did had to stay in the hospital longer and it cost more to treat them.

Article Abstract

Background: Despite the use of low-osmolar contrast media that have significantly reduced the occurrence of severe adverse reactions, contrast-induced (CI) acute kidney injury (AKI) remains the third cause of AKI in hospitals. We sought to estimate the frequency of CI-AKI among hospitalized patients undergoing image-guided cardiovascular procedures, to quantify the effect of risk factors on the development of this complication and to assess relative organizational and economic burden in healthcare.

Methods: A retrospective cross-sectional population-based study using the extensive French hospital discharge database (PMSI) was carried out. Hospitalizations with image-guided cardiovascular procedures using a contrast media were identified in adults over a 2-year period (2012-2013). Suspected CI-AKI was defined as the presence, during hospitalization, of a diagnostic code of AKI (International Classification of Diseases, 10th revision [ICD-10] codes: N141, 142, N144, N990, N17, N19 or R392) or a code of renal replacement therapy procedure (Classification Commune des Actes Médicaux [CCAM] codes: JVJB001, JVJF002-005 and JVJF008) as creatinine criteria were not available.

Results: During 1,047,329 hospitalizations studied, 32,308 suspected CI-AKI were observed, yielding a frequency of 3.1 %. By multivariate analysis, factors that significantly increased the risk of suspected CI-AKI included cardiogenic shock (odds ratio [OR] = 20.5, 95 % confidence interval [95 % CI] [18.7; 22.5]), acute heart failure (OR = 2.5, 95 % CI [2.4; 2.6]) and chronic kidney disease (OR = 2.3, 95 % CI [2.2; 2.3]. Renal replacement therapy was initiated during 6,335 (0.6 %) hospitalizations. The mean length of stay and cost of hospitalizations associated with suspected CI-AKI was higher than in hospitalizations without suspected CI-AKI (20.5 vs 4.7 days, p < 0.00001 and €15,765 vs €3,352, p < 0.0001, respectively).

Conclusions: This is the first large-scale population-based study to estimate frequency and health burden of suspected CI-AKI occurring after image-guided cardiovascular procedures, and the first available data in a French population. We showed that this iatrogenic complication remains of high concern despite prevention efforts and contrast media product improvement. From our results, suspected CI-AKI is associated with particularly high mortality, significantly extends hospitalizations, and leads to additional costs reaching a total of €200M per year.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100322PMC
http://dx.doi.org/10.1186/s12882-016-0385-5DOI Listing

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Article Synopsis
  • Scientists studied how often patients get a type of kidney injury called contrast-induced acute kidney injury (CI-AKI) when they have certain heart procedures in hospitals.
  • They looked at a lot of hospital records from France over two years and found that about 3.1% of those patients developed suspected CI-AKI.
  • Factors like heart failure and having existing kidney problems made it more likely for patients to get this injury, and those who did had to stay in the hospital longer and it cost more to treat them.
View Article and Find Full Text PDF

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