Background
Methods
Patient population
Data extraction
Independent variables
Outcomes
Statistical methods
Results
Population characteristics and AKI
Variable | No AKI | AKIN 1 | AKIN 2 | AKIN 3 | No AKI info |
---|---|---|---|---|---|
(n = 15,478) | (n = 3,067) | (n = 807) | (n = 588) | (n = 7,496) | |
Age - Mean (SD) | 62.0 (20.3) | 74.2 (16.3) | 76.1 (14.7) | 72.5 (15.7) | 54.2 (21.0) |
Age: 18-39 | 17.1% | 5.1% | 3.6% | 4.4% | 29.0% |
40-59 | 23.7% | 11.3% | 8.9% | 16.0% | 28.3% |
60-79 | 36.9% | 38.2% | 37.3% | 40.7% | 29.5% |
80+ | 22.3% | 45.5% | 50.2% | 39.0% | 13.2% |
Male Sex - % | 45.1% | 52.2% | 45.0% | 49.8% | 45.8% |
Deprivation - Median (IQR) | 17.4 (11.8 27.0) | 17.2 (11.8, 25.8) | 17.3 (11.8, 25.8) | 17.2 (11.9, 26.9) | 17.2 (11.7, 26.7) |
AIDS - % | 0.1% | 0.1% | 0.1% | 0.0% | 0.0% |
Malignancy - % | 6.2% | 11.5% | 14.0% | 16.7% | 4.8% |
CHF - % | 2.6% | 10.4% | 13.9% | 11.6% | 1.0% |
CPD - % | 12.8% | 17.0% | 16.1% | 17.4% | 8.5% |
Cerebrovascular disease - % | 7.3% | 13.5% | 12.3% | 11.2% | 3.4% |
Dementia - % | 3.2% | 6.7% | 8.2% | 7.0% | 1.9% |
Diabetes - % | 10.3% | 20.2% | 18.7% | 23.8% | 6.0% |
Hemiplegia. - % | 1.3% | 1.8% | 1.4% | 1.5% | 0.5% |
Hypertension - % | 27.2% | 39.% | 39.3% | 39.0% | 15.5% |
MI - % | 3.0% | 5.0% | 6.0% | 3.9% | 0.7% |
Solid tumour - % | 2.0% | 3.2% | 4.8% | 4.4% | 0.9% |
Liver disease - % | 0.9% | 1.8% | 3.0% | 6.1% | 0.5% |
PVD - % | 2.1% | 5.4% | 6.2% | 4.6% | 1.0% |
Peptic ulcer - % | 0.6% | 1.2% | 1.7% | 1.9% | 0.4% |
Renal disease - % | 1.7% | 11.2% | 16.4% | 22.3% | 1.1% |
Rheumatic disease - % | 2.3% | 3.9% | 3.1% | 4.1% | 1.1% |
CKD - no data | 0% | 0% | 0% | 0.7% | 34.4% |
no CKD | 84.8% | 61.9% | 62.1% | 68.2% | 58.0% |
CKD stage 3a | 10.0% | 19.1% | 20.1% | 15.0% | 5.0% |
CKD stage 3b | 4.0% | 13.1% | 12.1% | 10.2% | 2.0% |
CKD stage 4 | 1.0% | 5.3% | 5.5% | 2.6% | 0.5% |
CKD stage 5 | 0.2% | 0.5% | 0.2% | 3.4% | 0.1% |
Charlson ≤ 0 - % | 58.0% | 31.9% | 25.8% | 23.3% | 74.5% |
1-10 - % | 25.9% | 29.4% | 30.5% | 30.1% | 17.4% |
11 + =% | 16.2% | 38.8% | 43.7% | 46.6% | 8.2% |
Statistic | No AKI | AKIN 1 | AKIN 2 | AKIN 3 | No AKI info |
---|---|---|---|---|---|
(n = 20,464) | (n = 3,961) | (n = 927) | (n = 633) | (n = 10,030) | |
All patients | |||||
Mean (SD) | 4.5 (10.5) | 9.7 (14.6) | 12.3 (16.0) | 14.9 (18.5) | 2.3 (9.8) |
Median (IQR) | 2 (0, 5) | 5 (1, 12) | 7 (3, 15) | 9 (4, 20) | 1 (0, 2) |
Died in hospital | |||||
Mean (SD) | 11.1 (14.4) | 11.8 (16.3) | 10.0 (11.9) | 10.3 (12.2) | 13.5 (29.1) |
Median (IQR) | 6 (2, 14) | 6 (2, 15) | 6 (2, 14) | 6 (2, 14) | 5 (1, 15) |
Survived to hospital discharge | |||||
Mean (SD) | 4.4 (10.4) | 9.5 (14.5) | 13.0 (17.1) | 17.2 (120.5) | 2.1 (8.8) |
Median (IQR) | 1 (0, 5) | 5 (1, 11) | 8 (3, 15) | 11 (5, 22) | 1 (0, 2) |
Renal Replacement Therapy (RRT)
Survival analyses
Variable | No AKI | AKIN 1 | AKIN 2 | AKIN 3 |
---|---|---|---|---|
6 m survival (95% CI) | 0.94 (0.94, 0.94) | 0.77 (0.75, 0.78) | 0.48 (0.45, 0.52) | 0.39 (0.35, 0.43) |
12 m survival (95% CI) | 0.92 (0.92, 0.93) | 0.70 (0.68, 0.71) | 0.37 (0.34, 0.40) | 0.28 (0.25, 0.31) |
18 m survival (95% CI) | 0.91 (0.91, 0.92) | 0.65 (0.63, 0.66) | 0.32 (0.29, 0.35) | 0.22 (0.19, 0.25) |
24 m survival (95% CI) | 0.90 (0.89, 0.90) | 0.59 (0.58, 0.61) | 0.27 (0.24, 0.29) | 0.18 (0.16, 0.20) |
Risk of death | In-hospital mortality | ITU transfer | Increase in care | Hospital re-admission | Relative length of stay | Relative ITU length of stay | ||
---|---|---|---|---|---|---|---|---|
Model | Stage of AKI | Hazard ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | Ratio (95% CI) | Ratio (95% CI) |
1 | No AKI | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
AKIN 1 | 4.85 (4.51, 5.21) | 4.29 (3.68, 5.01) | 2.36 (1.90, 2.93) | 2.71 (2.17, 3.38) | 1.93 (1.75, 2.13) | 1.90 (1.84, 1.97) | 1.38 (1.13, 1.68) | |
AKIN 2 | 12.0 (11.0, 13.1) | 16.8 (13.5, 21.1) | 4.72 (3.36, 6.61) | 3.71 (2.56, 5.38) | 2.25 (1.83, 2.76) | 2.58 (2.43, 2.75) | 1.54 (1.17, 2.01) | |
AKIN 3 | 15.6 (14.2, 17.1) | 24.7 (18.8, 32.3) | 23.8 (16.4, 34.6) | 2.27 (1.36, 3.81) | 2.09 (1.61, 2.72) | 3.07 (2.85, 3.30) | 2.25 (1.85, 2.73) | |
2 | No AKI | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
AKIN 1 | 3.11 (2.89, 3.35) | 2.98 (2.53, 3.52) | 2.63 (2.11, 3.28) | 1.61 (1.29, 2.01) | 1.69 (1.53, 1.87) | 1.68 (1.62, 1.74) | 1.43 (1.17, 1.74) | |
AKIN 2 | 7.54 (6.89, 8.25) | 13.5 (10.5, 17.5) | 5.43 (3.88, 7.61) | 2.07 (1.43, 2.97) | 2.00 (1.63, 2.46) | 2.22 (2.09, 2.36) | 1.56 (1.20, 2.04) | |
AKIN 3 | 11.6 (10.6, 12.7) | 25.2 (18.6, 34.5) | 23.9 (16.6, 34.4) | 1.56 (0.93, 2.60) | 1.94 (1.49, 2.53) | 2.72 (2.53, 2.92) | 2.27 (1.88, 2.76) | |
3 | No AKI | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
AKIN 1 | 1.89 (1.74, 2.04) | 2.41 (1.99, 2.91) | 2.76 (2.20, 3.46) | 1.33 (1.06, 1.67) | 1.42 (1.29, 1.57) | 1.52 (1.47, 1.58) | 1.39 (1.14, 1.69) | |
AKIN 2 | 3.81 (3.46, 4.18) | 12.1 (8.84, 16.5) | 6.03 (4.58, 8.51) | 1.49 (1.02, 2.16) | 1.50 (1.23, 1.83) | 1.88 (1.77, 2.00) | 1.42 (1.07, 1.87) | |
AKIN 3 | 5.49 (4.97, 6.06) | 26.3 (17.8, 38.8) | 22.4 (15.5, 32.2) | 1.07 (0.64, 1.80) | 1.54 (1.20, 1.99) | 2.16 (2.01, 3.32) | 2.18 (1.77, 2.68) |