Abstract 16151: Acute Kidney Injury is a Powerful and an Independent Determinant of In-Hospital Mortality in Patients Undergoing Percutaneous Coronary Interventions
Introduction: Acute kidney injury (AKI) is a common complication of percutaneous coronary intervention (PCI) and is associated with increased mortality. Previous studies analysing mortality risk in patients with AKI were hampered by common risk factors for both outcomes. The aim of our study was to analyse the association between AKI and in-hospital mortality post PCI after adjustment for confounding by common risk factors.
Methods: This study was performed using data from a regional registry of patients undergoing PCI in the state of Michigan. The primary endpoints were AKI and all-cause in-hospital mortality. Propensity matching was performed, with each AKI patient matched to four controls. Attributive risk (AR) and the exposed impact number of AKI for mortality were calculated in the propensity-matched cohort.
Results: Between January 2009 and June 2013, 92,317 patients were included, of whom 2,141(2.3%) developed AKI. We matched 1,371/2,141 patients with AKI to 5,484 controls. AKI was strongly associated with mortality (OR = 12.52, 95% CI 9.29 - 16.86, p < 0.0001) after adjustment for baseline covariates in the propensity-matched cohort. The association between AKI and mortality was present in all subgroups and strata of baseline AKI-risk (Figure 1). The estimated AR for mortality of AKI was 31.4% (95% CI 26.8% - 37.5%). Among matched patients with AKI, one death could be prevented for every 9 cases of AKI successfully eliminated.
Conclusion: Our results indicate that AKI attributes to nearly one-third of the in-hospital mortality post PCI. Preventing nine cases of AKI could potentially prevent one death. These study findings stress the need for highly effective AKI preventive strategies.
Author Disclosures: J. Kooiman: None. M. Seth: None. B.K. Nallamothu: None. M. Heung: None. D. Humes: None. H.S. Gurm: None.
- © 2014 by American Heart Association, Inc.