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अमूर्त

Trends, In-Hospital Outcomes, and Independent Predictors of Acute Kidney Injury in Patients Admitted for the Management of Myocardial Infarction with Percutaneous Coronary Intervention: An Insight from the National Inpatient Sample Database

Akanimo Antia1*, Daniel Ubokudom2, Olanrewaju Adabale3, Ovie Okorare4, Emmanuel Daniel5, Endurance Evbayekha6, Chinwendu Angel Onuegbu7, Kenneth Ong8

Background: Acute Kidney Injury (AKI) is an important risk factor associated with adverse outcomes in cardiovascular illnesses, more importantly, Myocardial Infarction (MI). This study describes the Trends, in-hospital outcomes, and independent predictors of Acute Kidney Injury (AKI) in patients admitted for Myocardial infarction with Percutaneous Coronary Intervention (PCI).

Methods: This retrospective study used patient records from the 2016-2020 National In-patient Database (NIS). We identified patients who were admitted for the management of an MI who had a PCI procedure and an AKI and evaluated their associated socio-demographic and comorbid factors using International Classification of Diseases-10 (ICD-10) codes. The chi-square test was used to compare baseline characteristics between our populations with and without AKI and outcomes and multivariate logistic regression to identify independent predictors of AKI.

Results: There were 1,551,630 patients admitted for an MI and PCI, with 15% having an AKI. We observed that our population with AKI were older on admission and were more likely to be whites than blacks. A higher percentage were males. Our subpopulation was likely to have heart failure, atrial fibrillation, coronary artery disease, obesity, CKD and Charlson comorbidity index ≥ 3. A diagnosis of AKI was associated with higher in-hospital mortality rates (adjusted Odds Ratio (aOR): 2.84, CI: 2.7-3.02, p<0.001), longer mean Length Of Stay (LOS) and higher hospital costs. We noted an increasing trend in the percentage of patients who had an AKI, from about 13.5% in 2016 to 16.5% in 2020.

Conclusions: Acute Kidney Injury is strongly associated with worse hospital outcomes in patients admitted for MI and PCI, with higher mortality rates, a longer mean length of stay, and a higher hospitalization cost. A more concise look at preventive measures is recommended to minimize these outcomes.