Abstract: FR-PO928

Octogenarians in the Emergency Room: AKI, Risk Factors, and Outcomes

Session Information

  • Geriatric Nephrology
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

  • 901 Geriatric Nephrology

Authors

  • Abu Alfeilat, Mohsen, Share Zedek Medical Center, Jerusalem, Israel
  • Slotki, Itzchak N., Share Zedek Medical Center, Jerusalem, Israel
  • Shavit, Linda, Shaare Zedek Medical Center, Jerusalem, Israel
Background

The prevalence of acute kidney injury (AKI) in the elderly is growing and the prognosis is dismal. The structural and functional changes of the aging kidney, multiple comorbidities and exposure to medications explain this susceptibility to AKI in elderly. The aim of this study was to evaluate the incidence, risk factors, clinical characteristics and outcomes of AKI in octogenarians admitted to the emergency room (ER) and to compare these parameters with those in a younger group of patients admitted in the same period.

Methods

This is a prospective, observational, single center study that enrolled adult patients admitted to the ER of Shaare Zedek Medical Center, Jerusalem, Israel. Patients were stratified by age (> or < 80 years) and followed up prospectively until discharge. Incidence of AKI, in hospital mortality and duration of hospital stay were recorded.

Results

Of 319 patients, 128 were octogenarians (mean age 86.7, range 80 to 105) and 191 were younger (mean age 60.6, range 18 to 79). The incidence of AKI and in hospital mortality was significantly higher in octogenarians (16.4 % vs 12.6 %, p= 0.039 and 15.6% vs 3.1 %, p= 0.001, respectively). In univariate analyses, sepsis and low blood pressure were associated with AKI in octogenarians, whereas history of CVA or CKD, hypoalbuminemia and anemia were associated with AKI in the younger group. In multivariate analysis, only low systolic blood pressure (SBP) at admission in octogenarians (p=0.002) and history of CKD and hypoalbuminemia in the younger patients (p<0.001; p=0.001) were independent risk factors for AKI.

Conclusion

Our results confirm the observation that AKI is common in octogenarians and is associated with significantly higher mortality. We identified SBP as the only independent variable associated with AKI. However, the role of therapeutic strategies aimed to increase SBP and diminish complications in octogenarians remains to be elucidated.