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Causes of Death after a Hospitalization with AKI.
- Source :
-
Journal of the American Society of Nephrology : JASN [J Am Soc Nephrol] 2018 Mar; Vol. 29 (3), pp. 1001-1010. Date of Electronic Publication: 2017 Dec 14. - Publication Year :
- 2018
-
Abstract
- Mortality after AKI is high, but the causes of death are not well described. To better understand causes of death in patients after a hospitalization with AKI and to determine patient and hospital factors associated with mortality, we conducted a population-based study of residents in Ontario, Canada, who survived a hospitalization with AKI from 2003 to 2013. Using linked administrative databases, we categorized cause of death in the year after hospital discharge as cardiovascular, cancer, infection-related, or other. We calculated standardized mortality ratios to compare the causes of death in survivors of AKI with those in the general adult population and used Cox proportional hazards modeling to estimate determinants of death. Of the 156,690 patients included, 43,422 (28%) died in the subsequent year. The most common causes of death were cardiovascular disease (28%) and cancer (28%), with respective standardized mortality ratios nearly six-fold (5.81; 95% confidence interval [95% CI], 5.70 to 5.92) and eight-fold (7.87; 95% CI, 7.72 to 8.02) higher than those in the general population. The highest standardized mortality ratios were for bladder cancer (18.24; 95% CI, 17.10 to 19.41), gynecologic cancer (16.83; 95% CI, 15.63 to 18.07), and leukemia (14.99; 95% CI, 14.16 to 15.85). Along with older age and nursing home residence, cancer and chemotherapy strongly associated with 1-year mortality. In conclusion, cancer-related death was as common as cardiovascular death in these patients; moreover, cancer-related deaths occurred at substantially higher rates than in the general population. Strategies are needed to care for and counsel patients with cancer who experience AKI.<br /> (Copyright © 2018 by the American Society of Nephrology.)
- Subjects :
- Acute Kidney Injury therapy
Age Factors
Aged
Aged, 80 and over
Cardiovascular Diseases epidemiology
Comorbidity
Databases, Factual
Diabetes Mellitus epidemiology
Female
Hospitalization
Humans
Hypertension epidemiology
Male
Middle Aged
Neoplasms drug therapy
Neoplasms epidemiology
Nursing Homes
Ontario epidemiology
Proportional Hazards Models
Risk Factors
Acute Kidney Injury epidemiology
Cardiovascular Diseases mortality
Cause of Death
Infections mortality
Neoplasms mortality
Survivors statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1533-3450
- Volume :
- 29
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of the American Society of Nephrology : JASN
- Publication Type :
- Academic Journal
- Accession number :
- 29242248
- Full Text :
- https://doi.org/10.1681/ASN.2017080882