Autori: Fabbian Fabio (1), De Giorgi Alfredo (2), Gozzi Dario (1), Pasin Mauro (1), Storari Alda (3), Gallerani Massimo (2), Manfredini Roberto (1).
Affiliazioni: (1) Department of Medical Sciences, Clinica Medica Unit, (2) Department of Internal Medicine, (3) Department of Specialized Medicine, Nephrology Unit, University Hospital St. Anna, Ferrara
Background: The relationship between in-hospital mortality (IHM) and acute renal failure (ARF) in older adults has not been fully assessed at a nationwide level. The aim of this study was to establish the association between AFR identified by data obtained from Italian Health Ministry database based on International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) and IHM.
Methods: We analyzed routinely collected hospitalization data of all patients aged ≥ 65 years, discharged with ARF identified by the presence of ICD-9-CM 584.xx as primary or secondary diagnosis, and extracted from the Italian Health Ministry database (January 2000 to December 2015). In the period considered, a total of 760,664 hospitalizations mentioning ARF were included for analysis. Data regarding age, gender, dialysis treatment and comorbidity were collected, and factors independently associated with IHM were evaluated by a multivariate logistic regression.
Results: Mean age was 80.5±7.8 years, males were 52.2%, 9% underwent dialysis treatment, and the mean comorbidity score was more than 5. Overall IHM was 27.7% (210,661 admissions), deceased patients were older, more likely to be men undergoing dialysis treatment, and they were sicker than survivors. Comorbidity (OR 1.042; 95%CI 1.041-1.043, p<0.001) and undergoing dialysis treatment (OR 2.427; 95%CI 2.388-2.466, p<0.001) were independently associated with IHM.
Conclusions: In older adults admitted because of ARF, IHM is a frequent complication affecting more than a quarter of the investigated population. Major risk factors for IHM were comorbidity and the need of dialysis treatment.