AKI, a common complication in hospitalized patients, is associated with increased short- and long-term mortality. For a study, researchers sought to examine if there were any trends in the in-hospital and one-year mortality from AKI, as defined by the Kidney Disease Improving Global Outcomes consensus criteria. The retrospective cohort research analyzed data from the national Veterans Health Administration on all patients hospitalized between October 1, 2008, and September 31, 2017. Kidney Disease Improving Global Outcomes serum creatinine criteria were used to determine AKI. Using Cox regression with year as a continuous variable, in-hospital and 1-year death trends in patients with and without AKI were examined.
Over the course of the trial, they counted 1,688,457 patients and 2,689,093 hospitalizations. Among AKI patients, 6% died in the hospital, and 28% died within a year. In comparison, non-AKI hospitalizations had in-hospital and 1-year death rates of 0.8% and 14%, respectively. There was a small decrease in crude in-hospital AKI-associated mortality throughout the research period (hazard ratio, 0.98 per year; 95% CI, 0.98 to 0.99) that was mitigated after accounting for patient demographics, concomitant diseases, and acute hospitalization features (adjusted hazard ratio, 0.99 per year; 95% CI, 0.99 to 1.00). At 1 year, the consistent temporal pattern in mortality continued (adjusted hazard ratio, 1.00 per year; 95% CI, 0.99 to 1.00).
AKI-related mortality remained high, with more than 1 in every 4 patients dying within a year after being admitted to the hospital. There appeared to have been no major progress toward improving in-hospital or long-term AKI survivability over the last decade.