AI Article Synopsis
- Acute kidney injury (AKI) is more common in medical ICU patients (48.7%) compared to surgical ICU patients (19.7%), with medical patients also experiencing more severe cases.
- In surgical patients, hospital-acquired AKI is more prevalent, while medical patients have higher instances of community-acquired AKI.
- AKI significantly increases in-hospital mortality risk, with surgical patients facing a 4.8 times higher risk than non-AKI patients, highlighting the need for better prevention and management strategies in surgical settings.*
Article Abstract
Background: Though acute kidney injury (AKI) is a prevalent complication in critically ill patients, knowledge on the epidemiological differences and clinical characteristics of patients with AKI admitted to medical and surgical intensive care units (ICUs) remains limited.
Methods: Electronic medical records of patients in ICUs in Pusan National University Hospital and Pusan National University Hospital Yangsan, from January 2011 to December 2020, were retrospectively analyzed. Different characteristics of AKI between patients were analyzed. The contribution of AKI to the in-hospital mortality rate was assessed using a Cox proportional hazards model.
Results: A total of 7,150 patients were included in this study. AKI was more frequent in medical (48.7%) than in surgical patients (19.7%), with the severity of AKI higher in medical patients. In surgical patients, hospital-acquired AKI was more frequent (51.0% vs. 49.0%), whereas community-acquired AKI was more common in medical patients (58.5% vs. 41.5%). 16.9% and 5.9% of medical and surgical patients died in the hospital, respectively. AKI affected patient groups to different degrees. In surgical patients, AKI patients had 4.778 folds higher risk of mortality (95% confidence interval [CI], 3.577-6.382; p < 0.001) than non-AKI patients; whereas in medical AKI patients, it was 1.239 (95% CI, 1.051-1.461; p = 0.01).
Conclusion: While the prevalence of AKI itself is higher in medical patients, the impact of AKI on mortality was stronger in surgical patients compared to medical patients. This suggests that more attention is needed for perioperative patients to prevent and manage AKI.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237328 | PMC |
| http://dx.doi.org/10.23876/j.krcp.23.312 | DOI Listing |
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