Abstract: FR-PO059

A 10-Year National Trend in AKI among Hospitalized Adults Undergoing Invasive Cardiac Electrophysiology Studies

Session Information

  • AKI Clinical: Predictors
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Wen, Yumeng, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Pan, Di, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Mariuma, David, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Vazquez de lara, Fernando, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Luo, Yiming, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
  • Gramuglia, Michael, Montefiore Medical Center, Scarsdale, New York, United States
  • Meisels, Ira S., Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
Background

Invasive cardiac electrophysiology (EP) study is a collection of clinical techniques for investigation and treatment of cardiac rhythm disorders. Limited literature has addressed the risk of acute kidney injury (AKI) following invasive EP procedures. The aim of this study is to analyze the temporal trend of AKI among patients undergoing invasive cardiac EP studies, as well as in-hospital mortality and other outcomes among those developed AKI between 2005 and 2014.

Methods

This is a retrospective study using the 2005-2014 National Inpatient Sample, which is the largest publically available inpatient database in the United States. A cohort of 962,394 patients over the age of 18 undergoing invasive cardiac EP studies based on ICD-9 CM codes was included in the study. There were no exclusion criteria. In the primary analysis, we examined the temporal trend in the incidence of AKI and dialysis-requiring AKI. In the secondary analysis, we examined temporal changes in in-hospital mortality, length of stay (LOS), and total charges in hospitalizations complicated by AKI over the study time period. Odds ratios (OR) were calculated based on multivariate logistic analyses, adjusted for demographics and comorbidities. Analysis was performed using Stata, version 14.2.

Results

Our results showed that from 2005 to 2014 there was a significant increase in the incidence of AKI (3.26% in 2005 vs. 13.03% in 2014, p<0.001), as well as in dialysis-requiring AKI (0.22% in 2005 vs. 0.61% in 2014, p<0.001). Among those who developed AKI, the in-hospital mortality rate remained stable over time (OR 0.96, p=0.071). The LOS decreased significantly (15.85 days in 2005 vs. 11.22 days in in 2014, p<0.001), along with an increase in total hospital charges over time ($151,369 in 2005 vs. $193,384 in 2014, p<0.001). Hospitalizations complicated by AKI compared to those that were not were associated with significant higher in-hospital mortality (OR 3.77, p<0.001).

Conclusion

Our study demonstrated a significant increase in the incidence of AKI and dialysis-requiring AKI among patients undergoing invasive cardiac EP studies, however in-hospital mortality remained the same over time. Development of AKI after invasive cardiac EP studies was associated with higher hospital mortality rate and financial burden.