Single-center Study Of Community-acquired And Hospital-acquired Acute Kidney Injury

Objective: To retrospectively analyze the epidemiological data of community-acquired acute kidney injury(CA-AKI)and hospital-acquired acute kidney injury(HA-AKI)and to explore the risk factors affecting the death of CA-AKI and HA-AKI in hospitalized patients in this area,provide evidence for early identification of acute kidney injury(AKI)and limiting the risk factors of AKI.Method: Referring to the diagnostic criteria of HA-AKI and CA-AKI,querying the hospitalization data of all patients data from January 2012 to December 2016 use the hospital record system.The community acquired and hospital-acquired of inpatients in the area were retrospectively analyzed.Use the method of logistic regression to analyze the incidence and epidemiological data of acute kidney injury.At the same time,compared to the baseline data and epidemiological characteristics,associated with death both of two groups.Result: 1.A total of 20,457 patients were enrolled in the study.933 patients with acute kidney injury met the inclusion criteria,including 510 patients with HA-AKI and 423 CA-AKI,The incidence of CA-AKI was 2.07% and HA-AKI was 2.49% in all hospitalized patients,the overall incidence of acute kidney injury was 4.56%.2.The mean age of patients in the CA-AKI group was(62.3±16.0)years old,and the average age of patients in the HA-AKI group was(64.5±16.7)years old.The average age of patients in the CA-AKI group was younger about 2 years than the HA-AKI group.The average hospitalization days in the HA-AKI group was(15.4±7.3)days,which was longer than that in the CA-AKI group(14.1±7.9).Significant differences in average age,average hospitalization days,and average hospitalization expenses(P<0.05).3.About 43.9% of patients in the hospital-acquired acute kidney injury group progressed to AKI3 stage,and about 36.5% of patients in the CA-AKI group progressed to AKI3 stage.It is suggested that patients in the CA-AKI group are more likely to progress to AKI3 than those in the HA-AKI group.The all-cause mortality rate was 8.3%(77/933)in the HA-AKI group and 2.8%(26/933)in the CA-AKI group,suggesting that the HA-AKI group had a severe renal impairment,The disease progresses rapidly and the mortality rate is high than CA-AKI.4.Univariate logistic regression analysis indicated that age,cerebrovascular disease,NSAIDs,AKI3,and ICU were closely related to death in the CA-AKI group.5.Multivariate logistic regression analysis showed that ICU(OR=5.843)and cerebrovascular disease(OR=2.318),diuretics(OR=2.182),NSAIDs(OR=4.410),AKI3(OR=5.207)were affected by HA-AKI Independent risk factors for death in patients.Conclusion: 1.AKI is a common complication of hospitalized patients.AKI as well as CA-AKI and HA-AKI with a high incidence.2.Both HA-AKI and CA-AKI are common in elderly patients.HA-AKI can prolong the hospitalization period and increase the average hospitalization cost.3.The degree of kidney damage caused by HA-AKI is more serious,the disease progresses faster,and the mortality rate is higher.