Association between acute kidney injury and long-term mortality in patients with aneurysmal subarachnoid hemorrhage: A retrospective study

被引:4
作者
Xiao, Yangchun [1 ]
Wan, Jun [2 ]
Zhang, Yu [1 ,3 ]
Wang, Xing [3 ]
Zhou, Hanwen [4 ]
Lai, Han [5 ]
Chong, Weelic [6 ]
Hai, Yang [7 ]
Lunsford, L. Dade [8 ]
You, Chao [3 ]
Yu, Shui [9 ]
Fang, Fang [3 ]
机构
[1] Chengdu Univ, Affiliated Hosp, Dept Neurosurg, Chengdu, Peoples R China
[2] Chengdu Univ, Inst Higher Educ Sichuan Prov, Key Lab Pattern Recognit & Intelligent Informat Pr, Chengdu, Peoples R China
[3] Sichuan Univ, West China Hosp, Dept Neurosurg, Chengdu, Peoples R China
[4] Sichuan Univ, West China Sch Publ Hlth, Chengdu, Peoples R China
[5] Chongqing Med Univ, Affiliated Hosp 1, Dept Nephrol, Chongqing, Peoples R China
[6] Thomas Jefferson Univ, Dept Med Oncol, Philadelphia, PA USA
[7] Thomas Jefferson Univ, Dept Radiol, Philadelphia, PA USA
[8] Univ Pittsburgh, Med Ctr, Dept Neurosurg, Pittsburgh, PA USA
[9] Dujiangyan Peoples Hosp, Dept Neurosurg, Dujiangyan, Peoples R China
来源
FRONTIERS IN NEUROLOGY | 2022年 / 13卷
基金
国家重点研发计划;
关键词
intracranial aneurysm; subarachnoid hemorrhage; mortality; acute kidney injury; prognostic factors; complication; CLINICAL-PRACTICE GUIDELINES; ERBP POSITION STATEMENT; INTRACRANIAL ANEURYSMS; MANAGEMENT; OUTCOMES; CONSEQUENCES; EPIDEMIOLOGY; AKI;
D O I
10.3389/fneur.2022.864193
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BackgroundThough acute kidney injury (AKI) in the context of aneurysmal subarachnoid hemorrhage (aSAH) worsens short-term outcomes, its impact on long-term survival is unknown. AimWe aimed to evaluate the association between long-term mortality and AKI during hospitalization for aSAH. MethodsThis was a retrospective study of patients who survived >12 months after aSAH. All patients were evaluated at West China Hospital, Sichuan University, between December 2013 and June 2019. The minimum follow-up time was over 1 year. the maximum follow-up time was about 7.3 years. AKI was defined by the KDIGO (The Kidney Disease Improving Global Outcomes) guidelines, which stratifies patients into three stages of severity. The primary outcome was long-term mortality, which was analyzed with Kaplan-Meier curves and Cox proportional hazards models. ResultsDuring this study period, 238 (9.2%) patients had AKI among 2,592 patients with aSAH. We confirmed that AKI during care for aSAH significantly increased long-term mortality (median 4.3 years of follow-up) and that risk increased with the severity of the kidney failure, with an adjusted hazard ratio (HR) of 2.08 (95% CI 1.49-2.89) for stage 1 AKI, 2.15 (95% CI 1.05-4.43) for stage 2 AKI, and 2.66 (95% CI 1.08-6.53) for stage 3 AKI compared with patients without AKI. Among patients with an AKI episode, those with renal recovery still had increased long-term mortality (HR 1.96; 95% CI 1.40-2.74) compared with patients without AKI but had better long-term outcomes than those without renal recovery (HR 0.51, 95% CI 0.27-0.97). ConclusionsAmong 12-month survivors of aSAH, AKI during their initial hospitalization for aSAH was associated with increased long-term mortality, even for patients who had normal renal function at the time of hospital discharge. Longer, multidisciplinary post-discharge follow-up may be warranted for these patients.
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页数:8
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