Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock

Saraschandra Vallabhajosyula, Shannon M. Dunlay, Gregory W. Barsness, Saarwaani Vallabhajosyula, Shashaank Vallabhajosyula, Pranathi R. Sundaragiri, Bernard J. Gersh, Allan S. Jaffe, Kianoush Kashani

Research output: Contribution to journalArticle

Abstract

Background There are limited data on acute kidney injury (AKI) complicating acute myocardial infarction with cardiogenic shock (AMI-CS). This study sought to evaluate 15-year national prevalence, temporal trends and outcomes of AKI with no need for hemodialysis (AKI-ND) and requiring hemodialysis (AKI-D) following AMI-CS. Methods This was a retrospective cohort study from 2000–2014 from the National Inpatient Sample (20% stratified sample of all community hospitals in the United States). Adult patients (>18 years) admitted with a primary diagnosis of AMI and secondary diagnosis of CS were included. The primary outcome was in-hospital mortality in cohorts with no AKI, AKI-ND, and AKI-D. Secondary outcomes included predictors, resource utilization and disposition. Results During this 15-year period, 440,257 admissions for AMI-CS were included, with AKI in 155,610 (35.3%) and hemodialysis use in 14,950 (3.4%). Older age, black race, non-private insurance, higher comorbidity, organ failure, and use of cardiac and non-cardiac organ support were associated with the AKI development and hemodialysis use. There was a 2.6-fold higher adjusted risk of developing AKI in 2014 compared to 2000. Presence of AKI-ND and AKI-D was associated with a 1.3 and 1.7-fold higher adjusted risk of mortality. Compared to the cohort without AKI, AKI-ND and AKI-D were associated with longer length of stay (9±10, 12±13, and 18±19 days respectively; p<0.001) and higher hospitalization costs ($101,859 ±116,204, $159,804±190,766, and $265,875 ± 254,919 respectively; p<0.001). Conclusion AKI-ND and AKI-D are associated with higher in-hospital mortality and resource utilization in AMI-CS.

Original languageEnglish (US)
Article numbere0222894
JournalPloS one
Volume14
Issue number9
DOIs
StatePublished - Jan 1 2019

Fingerprint

hemodialysis
Cardiogenic Shock
myocardial infarction
Acute Kidney Injury
Renal Dialysis
Myocardial Infarction
kidneys
Insurance
Costs
Hospital Mortality
insurance
Community Hospital

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Vallabhajosyula, S., Dunlay, S. M., Barsness, G. W., Vallabhajosyula, S., Vallabhajosyula, S., Sundaragiri, P. R., ... Kashani, K. (2019). Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock. PloS one, 14(9), [e0222894]. https://doi.org/10.1371/journal.pone.0222894

Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock. / Vallabhajosyula, Saraschandra; Dunlay, Shannon M.; Barsness, Gregory W.; Vallabhajosyula, Saarwaani; Vallabhajosyula, Shashaank; Sundaragiri, Pranathi R.; Gersh, Bernard J.; Jaffe, Allan S.; Kashani, Kianoush.

In: PloS one, Vol. 14, No. 9, e0222894, 01.01.2019.

Research output: Contribution to journalArticle

Vallabhajosyula, S, Dunlay, SM, Barsness, GW, Vallabhajosyula, S, Vallabhajosyula, S, Sundaragiri, PR, Gersh, BJ, Jaffe, AS & Kashani, K 2019, 'Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock', PloS one, vol. 14, no. 9, e0222894. https://doi.org/10.1371/journal.pone.0222894
Vallabhajosyula, Saraschandra ; Dunlay, Shannon M. ; Barsness, Gregory W. ; Vallabhajosyula, Saarwaani ; Vallabhajosyula, Shashaank ; Sundaragiri, Pranathi R. ; Gersh, Bernard J. ; Jaffe, Allan S. ; Kashani, Kianoush. / Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock. In: PloS one. 2019 ; Vol. 14, No. 9.
@article{44b8e515acc3491bad70f6744c4cbf44,
title = "Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock",
abstract = "Background There are limited data on acute kidney injury (AKI) complicating acute myocardial infarction with cardiogenic shock (AMI-CS). This study sought to evaluate 15-year national prevalence, temporal trends and outcomes of AKI with no need for hemodialysis (AKI-ND) and requiring hemodialysis (AKI-D) following AMI-CS. Methods This was a retrospective cohort study from 2000–2014 from the National Inpatient Sample (20{\%} stratified sample of all community hospitals in the United States). Adult patients (>18 years) admitted with a primary diagnosis of AMI and secondary diagnosis of CS were included. The primary outcome was in-hospital mortality in cohorts with no AKI, AKI-ND, and AKI-D. Secondary outcomes included predictors, resource utilization and disposition. Results During this 15-year period, 440,257 admissions for AMI-CS were included, with AKI in 155,610 (35.3{\%}) and hemodialysis use in 14,950 (3.4{\%}). Older age, black race, non-private insurance, higher comorbidity, organ failure, and use of cardiac and non-cardiac organ support were associated with the AKI development and hemodialysis use. There was a 2.6-fold higher adjusted risk of developing AKI in 2014 compared to 2000. Presence of AKI-ND and AKI-D was associated with a 1.3 and 1.7-fold higher adjusted risk of mortality. Compared to the cohort without AKI, AKI-ND and AKI-D were associated with longer length of stay (9±10, 12±13, and 18±19 days respectively; p<0.001) and higher hospitalization costs ($101,859 ±116,204, $159,804±190,766, and $265,875 ± 254,919 respectively; p<0.001). Conclusion AKI-ND and AKI-D are associated with higher in-hospital mortality and resource utilization in AMI-CS.",
author = "Saraschandra Vallabhajosyula and Dunlay, {Shannon M.} and Barsness, {Gregory W.} and Saarwaani Vallabhajosyula and Shashaank Vallabhajosyula and Sundaragiri, {Pranathi R.} and Gersh, {Bernard J.} and Jaffe, {Allan S.} and Kianoush Kashani",
year = "2019",
month = "1",
day = "1",
doi = "10.1371/journal.pone.0222894",
language = "English (US)",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "9",

}

TY - JOUR

T1 - Temporal trends, predictors, and outcomes of acute kidney injury and hemodialysis use in acute myocardial infarction-related cardiogenic shock

AU - Vallabhajosyula, Saraschandra

AU - Dunlay, Shannon M.

AU - Barsness, Gregory W.

AU - Vallabhajosyula, Saarwaani

AU - Vallabhajosyula, Shashaank

AU - Sundaragiri, Pranathi R.

AU - Gersh, Bernard J.

AU - Jaffe, Allan S.

AU - Kashani, Kianoush

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background There are limited data on acute kidney injury (AKI) complicating acute myocardial infarction with cardiogenic shock (AMI-CS). This study sought to evaluate 15-year national prevalence, temporal trends and outcomes of AKI with no need for hemodialysis (AKI-ND) and requiring hemodialysis (AKI-D) following AMI-CS. Methods This was a retrospective cohort study from 2000–2014 from the National Inpatient Sample (20% stratified sample of all community hospitals in the United States). Adult patients (>18 years) admitted with a primary diagnosis of AMI and secondary diagnosis of CS were included. The primary outcome was in-hospital mortality in cohorts with no AKI, AKI-ND, and AKI-D. Secondary outcomes included predictors, resource utilization and disposition. Results During this 15-year period, 440,257 admissions for AMI-CS were included, with AKI in 155,610 (35.3%) and hemodialysis use in 14,950 (3.4%). Older age, black race, non-private insurance, higher comorbidity, organ failure, and use of cardiac and non-cardiac organ support were associated with the AKI development and hemodialysis use. There was a 2.6-fold higher adjusted risk of developing AKI in 2014 compared to 2000. Presence of AKI-ND and AKI-D was associated with a 1.3 and 1.7-fold higher adjusted risk of mortality. Compared to the cohort without AKI, AKI-ND and AKI-D were associated with longer length of stay (9±10, 12±13, and 18±19 days respectively; p<0.001) and higher hospitalization costs ($101,859 ±116,204, $159,804±190,766, and $265,875 ± 254,919 respectively; p<0.001). Conclusion AKI-ND and AKI-D are associated with higher in-hospital mortality and resource utilization in AMI-CS.

AB - Background There are limited data on acute kidney injury (AKI) complicating acute myocardial infarction with cardiogenic shock (AMI-CS). This study sought to evaluate 15-year national prevalence, temporal trends and outcomes of AKI with no need for hemodialysis (AKI-ND) and requiring hemodialysis (AKI-D) following AMI-CS. Methods This was a retrospective cohort study from 2000–2014 from the National Inpatient Sample (20% stratified sample of all community hospitals in the United States). Adult patients (>18 years) admitted with a primary diagnosis of AMI and secondary diagnosis of CS were included. The primary outcome was in-hospital mortality in cohorts with no AKI, AKI-ND, and AKI-D. Secondary outcomes included predictors, resource utilization and disposition. Results During this 15-year period, 440,257 admissions for AMI-CS were included, with AKI in 155,610 (35.3%) and hemodialysis use in 14,950 (3.4%). Older age, black race, non-private insurance, higher comorbidity, organ failure, and use of cardiac and non-cardiac organ support were associated with the AKI development and hemodialysis use. There was a 2.6-fold higher adjusted risk of developing AKI in 2014 compared to 2000. Presence of AKI-ND and AKI-D was associated with a 1.3 and 1.7-fold higher adjusted risk of mortality. Compared to the cohort without AKI, AKI-ND and AKI-D were associated with longer length of stay (9±10, 12±13, and 18±19 days respectively; p<0.001) and higher hospitalization costs ($101,859 ±116,204, $159,804±190,766, and $265,875 ± 254,919 respectively; p<0.001). Conclusion AKI-ND and AKI-D are associated with higher in-hospital mortality and resource utilization in AMI-CS.

UR - http://www.scopus.com/inward/record.url?scp=85072376353&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072376353&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0222894

DO - 10.1371/journal.pone.0222894

M3 - Article

C2 - 31532793

AN - SCOPUS:85072376353

VL - 14

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 9

M1 - e0222894

ER -