National outcomes of in-hospital cardiopulmonary resuscitation in patients with acute kidney injury: Years 2005 - 2011

Fahad Saeed, Malik M. Adil, Umar M. Kaleem, Abdus Salam Khan, Jean Lake Holley, Sevag Damirjian

Research output: Contribution to journalReview article

Abstract

Background: There is paucity of data on the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in patients with acute kidney injury (AKI). We analyzed the impact of acute kidney injury on in-hospital CPR-related outcomes. Materials and methods: We analyzed data from Nationwide Inpatient Sample (NIS 2005 - 2011) including patients with and without AKI who had undergone in-hospital CPR. Baseline characteristics, in-hospital complications and discharge outcomes were compared between the two groups. We determined the effect of AKI on length of hospital stay, discharge destination, hospital mortality, survival trends, and discharge to home. Results: 180,970 patients with primary or secondary diagnosis of AKI underwent in-hospital CPR compared to 323,620 patients without AKI. Unadjusted in-hospital mortality rates were higher in the AKI group (78.2 vs. 71.8%, p < 0.0001). After adjusting for age, sex, and potential confounders, patients in the AKI group had higher odds of mortality with odds ratio 1.3, 95% confidence interval 1.2 - 1.4, p < 0.0001. Survivors in the AKI group were more likely to be discharged to nursing homes and had higher mean hospitalization charges. In 2011 compared with 2005, there was an improved survival after CPR and higher rates of discharges to home. There was no significant change in the mean length of hospital stay between these time periods (p = 0.4). Conclusion: AKI independently increases the odds of in-hospital mortality and nursing home placement after in-hospital CPR. These data may facilitate CPR discussions and decision-making in critically ill patients.

Original languageEnglish (US)
Pages (from-to)325-333
Number of pages9
JournalClinical Nephrology
Volume90
Issue number5
DOIs
StatePublished - Nov 1 2018

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Cardiopulmonary Resuscitation
Acute Kidney Injury
Length of Stay
Hospital Mortality
Nursing Homes
Resuscitation Orders
Survival
Mortality
Critical Illness
Survivors
Inpatients
Decision Making
Hospitalization
Odds Ratio
Confidence Intervals

Keywords

  • Acute kidney injury
  • Cardiopulmonary resuscitation

ASJC Scopus subject areas

  • Nephrology

Cite this

National outcomes of in-hospital cardiopulmonary resuscitation in patients with acute kidney injury : Years 2005 - 2011. / Saeed, Fahad; Adil, Malik M.; Kaleem, Umar M.; Khan, Abdus Salam; Holley, Jean Lake; Damirjian, Sevag.

In: Clinical Nephrology, Vol. 90, No. 5, 01.11.2018, p. 325-333.

Research output: Contribution to journalReview article

Saeed, Fahad ; Adil, Malik M. ; Kaleem, Umar M. ; Khan, Abdus Salam ; Holley, Jean Lake ; Damirjian, Sevag. / National outcomes of in-hospital cardiopulmonary resuscitation in patients with acute kidney injury : Years 2005 - 2011. In: Clinical Nephrology. 2018 ; Vol. 90, No. 5. pp. 325-333.
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abstract = "Background: There is paucity of data on the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in patients with acute kidney injury (AKI). We analyzed the impact of acute kidney injury on in-hospital CPR-related outcomes. Materials and methods: We analyzed data from Nationwide Inpatient Sample (NIS 2005 - 2011) including patients with and without AKI who had undergone in-hospital CPR. Baseline characteristics, in-hospital complications and discharge outcomes were compared between the two groups. We determined the effect of AKI on length of hospital stay, discharge destination, hospital mortality, survival trends, and discharge to home. Results: 180,970 patients with primary or secondary diagnosis of AKI underwent in-hospital CPR compared to 323,620 patients without AKI. Unadjusted in-hospital mortality rates were higher in the AKI group (78.2 vs. 71.8{\%}, p < 0.0001). After adjusting for age, sex, and potential confounders, patients in the AKI group had higher odds of mortality with odds ratio 1.3, 95{\%} confidence interval 1.2 - 1.4, p < 0.0001. Survivors in the AKI group were more likely to be discharged to nursing homes and had higher mean hospitalization charges. In 2011 compared with 2005, there was an improved survival after CPR and higher rates of discharges to home. There was no significant change in the mean length of hospital stay between these time periods (p = 0.4). Conclusion: AKI independently increases the odds of in-hospital mortality and nursing home placement after in-hospital CPR. These data may facilitate CPR discussions and decision-making in critically ill patients.",
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N2 - Background: There is paucity of data on the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in patients with acute kidney injury (AKI). We analyzed the impact of acute kidney injury on in-hospital CPR-related outcomes. Materials and methods: We analyzed data from Nationwide Inpatient Sample (NIS 2005 - 2011) including patients with and without AKI who had undergone in-hospital CPR. Baseline characteristics, in-hospital complications and discharge outcomes were compared between the two groups. We determined the effect of AKI on length of hospital stay, discharge destination, hospital mortality, survival trends, and discharge to home. Results: 180,970 patients with primary or secondary diagnosis of AKI underwent in-hospital CPR compared to 323,620 patients without AKI. Unadjusted in-hospital mortality rates were higher in the AKI group (78.2 vs. 71.8%, p < 0.0001). After adjusting for age, sex, and potential confounders, patients in the AKI group had higher odds of mortality with odds ratio 1.3, 95% confidence interval 1.2 - 1.4, p < 0.0001. Survivors in the AKI group were more likely to be discharged to nursing homes and had higher mean hospitalization charges. In 2011 compared with 2005, there was an improved survival after CPR and higher rates of discharges to home. There was no significant change in the mean length of hospital stay between these time periods (p = 0.4). Conclusion: AKI independently increases the odds of in-hospital mortality and nursing home placement after in-hospital CPR. These data may facilitate CPR discussions and decision-making in critically ill patients.

AB - Background: There is paucity of data on the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in patients with acute kidney injury (AKI). We analyzed the impact of acute kidney injury on in-hospital CPR-related outcomes. Materials and methods: We analyzed data from Nationwide Inpatient Sample (NIS 2005 - 2011) including patients with and without AKI who had undergone in-hospital CPR. Baseline characteristics, in-hospital complications and discharge outcomes were compared between the two groups. We determined the effect of AKI on length of hospital stay, discharge destination, hospital mortality, survival trends, and discharge to home. Results: 180,970 patients with primary or secondary diagnosis of AKI underwent in-hospital CPR compared to 323,620 patients without AKI. Unadjusted in-hospital mortality rates were higher in the AKI group (78.2 vs. 71.8%, p < 0.0001). After adjusting for age, sex, and potential confounders, patients in the AKI group had higher odds of mortality with odds ratio 1.3, 95% confidence interval 1.2 - 1.4, p < 0.0001. Survivors in the AKI group were more likely to be discharged to nursing homes and had higher mean hospitalization charges. In 2011 compared with 2005, there was an improved survival after CPR and higher rates of discharges to home. There was no significant change in the mean length of hospital stay between these time periods (p = 0.4). Conclusion: AKI independently increases the odds of in-hospital mortality and nursing home placement after in-hospital CPR. These data may facilitate CPR discussions and decision-making in critically ill patients.

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