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Abstract: TH-PO039

Improved Mortality of Critically Ill Patients with AKI: Population-Based Cohort Study in Korea Between 2008 and 2015

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Hwang, Subin, Inje University Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea (the Republic of)
  • Koo, Ho seok, Inje University Seoul Paik Hospital, Inje University School of Medicine, Seoul, Korea (the Republic of)
  • Lee, Jung eun, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Huh, Wooseong, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yoon-Goo, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Kim, Dae Joong, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Oh, Ha Young, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Jang, Hye Ryoun, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
Background

Although there is still no specific treatment facilitating renal tubule regeneration in acute kidney injury (AKI), the rapid increase aging population with more comorbidities and advance in critical care management were expected to change the epidemiology of AKI. However, few recent studies dissecting the current epidemiology characteristics of critically ill patients with AKI. We investigated the recent epidemiologic changes of AKI in critically ill patients.

Methods

All adult admissions to intensive care units (ICU) in Korea from 2008 to 2015 were screened using the national health insurance review and assessment database, and a total of 1,744,235 patients were included. The clinical characteristics and change in incidence and mortality rate of AKI were analyzed.

Results

The incidence of AKI increased from 7.4% in 2008 to 8.3% in 2015 (p for trend <.001). The age-standardized AKI rates in were 7018.6 per 100,000 person-years. The in-hospital mortality was significantly decreased from 39.1% in 2008 to 37.2% in 2015 (p for trend <.001) with 2427.6 deaths per 100,000 person-years. Patients with AKI showed higher in-hospital mortality, prolonged ICU length of stay, and higher total cost. Multivariable analysis showed increased risk of in-hospital mortality (OR 6.25), mechanical ventilation (OR=4.63), ECMO (OR=18.22), and vasopressor requirement (OR=4.02) in AKI patients.

Conclusion

Recent advances in medical management for AKI have attenuated in-hospital mortality of critically ill patients with AKI despite increase of the elderly population as well as the incidence of AKI.