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Trends of Acute Kidney Injury Requiring Dialysis Among Hospitalized Patients Undergoing Invasive Electrophysiology Procedures
- Source :
- Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine. 19:98-103
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Electrophysiology (EP) procedures carry the risk of kidney injury due to contrast/hemodynamic fluctuations. We aim to evaluate the national epidemiology of acute kidney injury requiring dialysis (AKI-D) in patients undergoing EP procedures. Using the National Inpatient Sample, we included 2,747,605 adult hospitalizations undergoing invasive diagnostic EP procedures, ablation and implantable device placement from 2006 to 2014. We examined the temporal trend of AKI-D and outcomes associated with AKI-D. The rate of AKI-D increased significantly in both diagnostic/ablation group (8-21/10,000 hospitalizations from 2006 to 2014, P = 0.02) and implanted device group (19-44/10,000 hospitalizations from 2006 to 2014, P < 0.01), but it was explained by temporal changes in demographics and comorbidities. Cardiac resynchronization therapy and pacemaker placement had higher risk of AKI-D compared to implantable cardioverter-defibrillator placement (23 vs. 31 vs. 14/10,000 hospitalizations in cardiac resynchronization therapy, pacemaker placement, and implantable cardioverter-defibrillator group, respectively). Development of AKI-D was associated with significant increase in in-hospital mortality (adjusted odds ratio, 9.6 in diagnostic/ablation group, P < 0.01; adjusted odds ratio, 5.1 in device implantation group, P < 0.01) and with longer length of stay (22.5 vs. 4.5 days in diagnostic/ablation group, 21.1 vs. 5.7 days in implanted device group) and higher cost (282,775 vs. 94,076 USD in diagnostic/ablation group, 295,660 vs. 102,007 USD in implanted device group). The incidence of AKI-D after EP procedures increased over time but largely explained by the change of demographics and comorbidities. This increasing trend, however, was associated with significant increase in resource utilization and in-hospital mortality in these patients.
- Subjects :
- Male
Pacemaker, Artificial
medicine.medical_specialty
medicine.medical_treatment
Cardiac resynchronization therapy
030204 cardiovascular system & hematology
Severity of Illness Index
Prosthesis Implantation
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Renal Dialysis
Risk Factors
Sepsis
Internal medicine
Epidemiology
Humans
Medicine
Pacemaker Placement
Cardiac Resynchronization Therapy Devices
Hospital Mortality
Dialysis
Aged
Retrospective Studies
business.industry
Incidence
Incidence (epidemiology)
Acute kidney injury
Arrhythmias, Cardiac
Odds ratio
Acute Kidney Injury
Length of Stay
Middle Aged
medicine.disease
Ablation
Hospital Charges
Respiration, Artificial
Defibrillators, Implantable
Hospitalization
Catheter Ablation
Cardiology
Female
Electrophysiologic Techniques, Cardiac
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 1535282X
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine
- Accession number :
- edsair.doi.dedup.....c7bd39582a2dc2fd8f0a78f0e218284c