Abstract T MP76: Acute Kidney Injury in Acute Ischemic Strokes is Associated with Worse Outcomes
Background: Acute Kidney Injury (AKI) in setting of acute ischemic stroke (AIS) is associated with worse outcome.
Objective: To determine the effect of AKI on outcomes of AIS patients treated in a large national cohort. In a sub-analysis we looked at the outcomes of AKI in AIS patients treated with and without thrombolytic.
Methods: Data from all patients admitted to US hospitals between 2002 and 2010 with a primary discharge diagnosis of ischemic stroke and secondary diagnosis of AKI treated with or without IV thrombolysis were included. The effect of AKI on rates of intracerebral hemorrhage (ICH) and discharge outcomes was analyzed after adjusting for potential confounders using logistic regression analysis.
Results: Of 7,068,334 patients with AIS, 372,223 (5.3%) had AKI. AIS patients with AKI had higher rates of moderate to severe disability (41.3% versus 30% p=<0.0001), ICH (1.0% versus 0.5% p=<0.0001) and In-hospital mortality (8.4% versus 2.9% p=<0.0001) compared to those without AKI. After adjusting for potential confounders AIS patients with AKI had higher odds of moderate to severe disability [Odds ratio (OR) 1.4, 95% confidence interval (CI) (1.3-1.4, p=<0.0001)], ICH [(OR) 1.6, 95% (CI) (1.5-1.8, p=<0.0001)] and death [(OR) 2.6, 95% (CI) (2.5-2.8, p=<0.0001)]. In a sub-analysis, AIS patients with AKI who were treated with thrombolytic had higher rates of moderate to severe disability (54.5% versus 41.1% p=<0.0001), ICH (7.4% versus 0.8% p=<0.0001) and In-hospital mortality (21.4% versus 8.2% p=<0.0001) compared to those were not treated with thrombolytic. After adjusting for potential confounders AIS patients with AKI who were treated with thrombolytic had higher odds of moderate to severe disability [(OR) 1.7, 95% (CI) (1.5-2.0, p=<0.0001)], ICH [(OR) 8.0, 95% (CI) (6.1-10.2, p=<0.0001)] and death [(OR) 2.7, 95% (CI) (2.3-3.2, p=<0.0001)] compared to those were not treated with thrombolytic.
Conclusion: AKI in patients with AIS is associated with significantly higher rates of disability at discharge, ICH and in-hospital mortality. In such patients, administration of thrombolytic treatment further worsens the outcome.
Author Disclosures: F. Khursheed: None. M.M. Adil: None. F. Saeed: None. L.A. Branch: None. G.A. Vidal: None. A.I. Qureshi: None.
- © 2014 by American Heart Association, Inc.