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• W4387249286 abstract "SESSION TITLE: Critical Care Posters 17 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: To explore cardiovascular risk factors and outcomes in critically ill adults with acute kidney injury requiring continuous renal replacement therapy (CRRT). METHODS: All adult admissions complicated by acute kidney injury requiring the use of CRRT were analyzed using admissions from the National Inpatient Sample database between January 2018 and December 2019. Analyzed outcomes included in-hospital mortality, in-hospital complications, clinical comorbidities, and resource use (including total hospital charges and length of stay). We used multivariate logistics and Elixhauser comorbidities to adjust for clinical comorbidities. RESULTS: Between January 2018 and December 2019, a total of 1,852,678 patients experienced AKI during hospitalization. Of those patients, 12,302 required CRRT. Overall in-hospital mortality rate during the study period was statistically greater in the CRRT group (54.76%) compared to the non-CRRT group (6.67%; p < 0.001). Controlling for clinical comorbidities, patients requiring CRRT compared to those not requiring CRRT were associated with significantly higher odds of in-hospital mortality (adjusted odds ratio [aOR]: 8.68; 95% Confidence Interval [CI]: 7.89 to 9.54; p < 0.001). Those with atrial flutter (aOR: 1.78; 95% CI:1.54 to 2.06; p < 0.001) and hypertension (aOR: 1.74; 95% CI: 1.51 to 2.01; p < 0.001) were associated with increased odds of requiring CRRT. In addition, compared to those with a BMI of 19-24, patients with a BMI of 30-35 (aOR: 3.70; 95% CI: 3.04 to 4.48; p < 0.001) and BMI of >40 (aOR: 6.47; 95% CI: 5.30 to 7.91; p < 0.001) were significantly associated with increased odds of requiring CRRT in the setting of AKI. Among the most common complications experienced by patients requiring CRRT, 21.3% had anemia requiring blood transfusions and 2.87% of patients experienced sepsis. Average length of stay was 17.65 days and average cost of stay was $373,802 in those receiving CRRT. When controlling for Elixhauser comorbidities, age and length of stay, compared to white patients being the reference group, Hispanics and Asians and Pacific Islanders had a significantly increased (p < 0.001) average total cost of stay. However, in-hospital mortality was not significantly associated with average total charges when controlling for the same parameters. CONCLUSIONS: In-hospital mortality rates are still significantly elevated despite advances in medical management of patients with AKI. Patients with atrial flutter and hypertension were significantly associated with requiring CRRT in the setting of acute kidney injury. Racial, ethnic and gender disparities remain present in patients with AKI requiring CRRT and would benefit from further studies. CLINICAL IMPLICATIONS: The significant difference in in-hospital mortality between patients with AKI requiring and not requiring CRRT highlights the importance of close monitoring and management of high risk patients. Clinicians should also be mindful of the racial, ethnic and gender disparities that play a significant role in outcomes of critically ill patients. DISCLOSURES: No relevant relationships by SHAHARYAR ALI No relevant relationships by Subhash Chander No relevant relationships by Wenchy Siu No relevant relationships by Samuel Tan No relevant relationships by Hong Yu Wang" @default.
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• W4387249286 date "2023-10-01" @default.
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• W4387249286 title "CARDIOVASCULAR RISK FACTORS ASSOCIATED WITH ACUTE KIDNEY INJURY REQUIRING CONTINUOUS RENAL REPLACEMENT THERAPY" @default.
• W4387249286 doi "https://doi.org/10.1016/j.chest.2023.07.1133" @default.
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