Academic Journal
Increasing incidence of acute kidney injury in pediatric severe sepsis and related adverse hospital outcomes.
| Τίτλος: | Increasing incidence of acute kidney injury in pediatric severe sepsis and related adverse hospital outcomes. |
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| Συγγραφείς: | Khatana J; Department of Pediatrics, Metro Health Medical Center, Case Western Reserve University, Cleveland, USA., Thavamani A; Division of Pediatric Gastroenterology, Hepatology, and Nutrition Department of Pediatrics, UH Rainbow Babies and Children's Hospital/Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA. aravindjt@gmail.com., Umapathi KK; Department of Pediatrics, West Virginia University, Morgantown, USA., Sankararaman S; Division of Pediatric Gastroenterology, Hepatology, and Nutrition Department of Pediatrics, UH Rainbow Babies and Children's Hospital/Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA., Roy A; Department of Pediatrics, Metro Health Medical Center, Case Western Reserve University, Cleveland, USA. |
| Πηγή: | Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2023 Aug; Vol. 38 (8), pp. 2809-2815. Date of Electronic Publication: 2023 Jan 09. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer International Country of Publication: Germany NLM ID: 8708728 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-198X (Electronic) Linking ISSN: 0931041X NLM ISO Abbreviation: Pediatr Nephrol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Berlin : Springer International Original Publication: Berlin : Springer International, c1987- |
| Ιατρικοί όροι (MeSH): | Sepsis*/complications , Sepsis*/epidemiology , Acute Kidney Injury*/epidemiology , Acute Kidney Injury*/therapy , Acute Kidney Injury*/diagnosis, Humans ; Child ; Incidence ; Retrospective Studies ; Hospitalization ; Risk Factors ; Hospitals ; Hospital Mortality |
| Περίληψη: | Background: Pediatric severe sepsis (PSS) is associated with increased mortality, and acute kidney injury (AKI) is an independent risk factor of mortality in PSS. However, there is little data on impact of AKI on hospital outcomes in PSS. Methods: We analyzed non-overlapping years of the Kids' Inpatient Database (KID) and National Inpatient Sample (NIS) database between 2003 and 2019 of all pediatric patients with severe sepsis between 1 and 18 years of age. Using ICD diagnosis codes, patients were divided into two groups based on AKI status and compared for outcomes measures including in-hospital mortality and healthcare resource utilization using length of stay and inflation-adjusted hospitalization charges. Results: We analyzed 192,712 hospitalizations due to PSS during the 17-year period. Prevalence of AKI was 23.6% with overall increasing trend, P<0.001. Prevalence of AKI was significantly increased in patients with diabetes mellitus, organ transplantation, HIV, urinary tract anomalies, and malnutrition, P<0.001. Mortality rate was significantly higher among patients with AKI (19.8% vs. 8.1%, P<0.001). PSS with AKI had significantly higher median length of stay (14 vs. 11 days) and total hospitalization charges ($168,106 vs. 100,906), P<0.001. Multivariate logistic regression analysis showed that AKI without kidney replacement therapy (KRT) was associated with 3.02 times increased odds of mortality (95% CI 2.99-3.17, P<0.001) and those requiring KRT had 6.4 times increased odds of mortality (95%CI 6.1-6.7, P<0.001). AKI without KRT was associated with 7.7 (95% CI 7.3-8.05) additional days of hospitalization and 154,536 (95% CI 149,500-159,572) additional US dollars in hospitalization charges. Conclusion: Almost 1 in 4 hospitalizations with PSS had AKI and was associated with >3 times increased risk of mortality and need for KRT further adversely impacts mortality and healthcare utilization. A higher resolution version of the Graphical abstract is available as Supplementary information. (© 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.) |
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| Contributed Indexing: | Keywords: Acute kidney injury; Acute pancreatitis; Mortality; Population-based study; Severe sepsis |
| Entry Date(s): | Date Created: 20230109 Date Completed: 20230802 Latest Revision: 20261010 |
| Update Code: | 20261010 |
| DOI: | 10.1007/s00467-022-05866-x |
| PMID: | 36622440 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1432-198X |
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| DOI: | 10.1007/s00467-022-05866-x |