Document Type
Article
Publication Date
9-1-2022
Abstract
Background: Though acute kidney injury (AKI) in the context of aneurysmal subarachnoid hemorrhage (aSAH) worsens short-term outcomes, its impact on long-term survival is unknown.
Aim: We aimed to evaluate the association between long-term mortality and AKI during hospitalization for aSAH.
Methods: This 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.
Results: During 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).
Conclusions: Among 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.
Recommended Citation
Xiao, Yangchun; Wan, Jun; Zhang, Yu; Wang, Xing; Zhou, Hanwen; Lai, Han; Chong, Weelic; Hai, Yang; Lunsford, L Dade; You, Chao; Yu, Shui; and Fang, Fang, "Association Between Acute Kidney Injury and Long-Term Mortality in Patients With Aneurysmal Subarachnoid Hemorrhage: A Retrospective Study" (2022). Department of Medical Oncology Faculty Papers. Paper 206.
https://jdc.jefferson.edu/medoncfp/206
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
36119706
Language
English
Comments
This article is the author’s final published version in Frontiers in Neurology, Volume 13, September 2022, Article number 864193.
The published version is available at https://doi.org/10.3389/fneur.2022.864193. Copyright © Xiao et al.