Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic Implications
Introduction Subarachnoid Hemorrhage (SAH) resulting from the spontaneous rupture of an aneurysm is a rare and highly debilitating condition. Despite its severity, patients with aneurysmal SAH remain understudied, particularly concerning the evaluation of the incidence and consequences of subsequent...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-11-01
|
| Series: | Stroke: Vascular and Interventional Neurology |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.022 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849714748078161920 |
|---|---|
| author | Galadu Subah Lee Hecht Bridget Nolan Aiden Lui Anaz Uddin Christina Ng Nitesh Damodara Chirag Gandhi Fawaz Al‐Mufti |
| author_facet | Galadu Subah Lee Hecht Bridget Nolan Aiden Lui Anaz Uddin Christina Ng Nitesh Damodara Chirag Gandhi Fawaz Al‐Mufti |
| author_sort | Galadu Subah |
| collection | DOAJ |
| description | Introduction Subarachnoid Hemorrhage (SAH) resulting from the spontaneous rupture of an aneurysm is a rare and highly debilitating condition. Despite its severity, patients with aneurysmal SAH remain understudied, particularly concerning the evaluation of the incidence and consequences of subsequent acute kidney injury (AKI). Thus, the objective of this study was to explore the predictors and ramifications of AKI in patients with aneurysmal SAH. Further research and attention to this area are crucial for improving patient outcomes and guiding clinical interventions in this challenging condition. Methods ICD‐10‐CM codes were used to query the National Inpatient Sample (NIS) for patients with AIS between 2010 and 2019. Subgroup analysis was stratified by the presence of a definitive AKI diagnosis. The AKI and non‐AKI groups were assessed for baseline clinical characteristics, interventions, complications, and outcomes. Descriptive statistics, multivariate regressions, and propensity score‐matching were all performed using IBM SPSS 28. Results 76,553 patients within the NIS were diagnosed with nontraumatic SAH between 2010 and 2019, of which 10,634 (13.89%) had a comorbid diagnosis of AKI. Patients with AKI were on average older (63.29 vs 61.07, p < 0.01), more often obese (12.15% vs 9.32%, p < 0.01), of the white race (55.82% vs 51%, p < 0.01), and considered long‐term users of anticoagulants (8.12% vs 5.34%, p < 0.01) when compared to the non‐AKI group. In terms of complications, patients within the AKI cohort had lower rates of decompressive hemicraniectomy (1.37% vs. 2.38%, p = 0.52) and, interestingly, cerebral vasospasms (4.47% vs. 8.22%, p < 0.01). However, AKI patients had higher rates of deep vein thrombosis (6.36% vs. 3.54%, p < 0.01), pulmonary embolism (4.22% vs. 1.42%, p < 0.01), pneumonia (21.39% vs. 8.84%, p < 0.01), urinary tract infection (19.07% vs. 13.32%, p < 0.01), sepsis (20.27% vs. 4.18%, p < 0.01), acute myocardial infarction (12.14% vs. 3.21%, p < 0.01), and cardiac arrest (10.25% vs. 3.23%, p < 0.01). In a multivariate regression assessing the impact of AKI on SAH outcome, this diagnosis was found to be independently correlated with poor functional outcome (OR: 3.306, CI: 3.11 – 3.513, p < 0.001) above average LOS (OR: 1.503, CI: 1.438 ‐ 1.571, p <0.001), and in‐hospital mortality (OR: 2.434, CI: 2.323 ‐ 2.55, p <0.001), when controlling for admission age, SAH severity, and other significant comorbidities. Conclusion The findings of this national database evaluation reveal a significant association between AKI and adverse outcomes in patients with aneurysmal SAH. Specifically, the study highlights a strong correlation between AKI and heightened complication rates, poor functional outcome, extended hospital stays, and elevated mortality rates. These results emphasize the importance of early detection and proactive management of AKI in SAH patients to improve their overall prognosis and enhance their chances of recovery. |
| format | Article |
| id | doaj-art-a129aae6046c46c39ccecf51f7f4c4b5 |
| institution | DOAJ |
| issn | 2694-5746 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj-art-a129aae6046c46c39ccecf51f7f4c4b52025-08-20T03:13:36ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-11-013S210.1161/SVIN.03.suppl_2.022Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic ImplicationsGaladu Subah0Lee Hecht1Bridget Nolan2Aiden Lui3Anaz Uddin4Christina Ng5Nitesh Damodara6Chirag Gandhi7Fawaz Al‐Mufti8Westchester Medical Center New York United StatesNew York Medical College New York United StatesNew York Medical College New York United StatesNew York Medical College New York United StatesNew York Medical College New York United StatesUniversity of Vermont VT United StatesWestchester Medical Center New York United StatesWestchester Medical Center New York United StatesWestchester Medical Center New York United StatesIntroduction Subarachnoid Hemorrhage (SAH) resulting from the spontaneous rupture of an aneurysm is a rare and highly debilitating condition. Despite its severity, patients with aneurysmal SAH remain understudied, particularly concerning the evaluation of the incidence and consequences of subsequent acute kidney injury (AKI). Thus, the objective of this study was to explore the predictors and ramifications of AKI in patients with aneurysmal SAH. Further research and attention to this area are crucial for improving patient outcomes and guiding clinical interventions in this challenging condition. Methods ICD‐10‐CM codes were used to query the National Inpatient Sample (NIS) for patients with AIS between 2010 and 2019. Subgroup analysis was stratified by the presence of a definitive AKI diagnosis. The AKI and non‐AKI groups were assessed for baseline clinical characteristics, interventions, complications, and outcomes. Descriptive statistics, multivariate regressions, and propensity score‐matching were all performed using IBM SPSS 28. Results 76,553 patients within the NIS were diagnosed with nontraumatic SAH between 2010 and 2019, of which 10,634 (13.89%) had a comorbid diagnosis of AKI. Patients with AKI were on average older (63.29 vs 61.07, p < 0.01), more often obese (12.15% vs 9.32%, p < 0.01), of the white race (55.82% vs 51%, p < 0.01), and considered long‐term users of anticoagulants (8.12% vs 5.34%, p < 0.01) when compared to the non‐AKI group. In terms of complications, patients within the AKI cohort had lower rates of decompressive hemicraniectomy (1.37% vs. 2.38%, p = 0.52) and, interestingly, cerebral vasospasms (4.47% vs. 8.22%, p < 0.01). However, AKI patients had higher rates of deep vein thrombosis (6.36% vs. 3.54%, p < 0.01), pulmonary embolism (4.22% vs. 1.42%, p < 0.01), pneumonia (21.39% vs. 8.84%, p < 0.01), urinary tract infection (19.07% vs. 13.32%, p < 0.01), sepsis (20.27% vs. 4.18%, p < 0.01), acute myocardial infarction (12.14% vs. 3.21%, p < 0.01), and cardiac arrest (10.25% vs. 3.23%, p < 0.01). In a multivariate regression assessing the impact of AKI on SAH outcome, this diagnosis was found to be independently correlated with poor functional outcome (OR: 3.306, CI: 3.11 – 3.513, p < 0.001) above average LOS (OR: 1.503, CI: 1.438 ‐ 1.571, p <0.001), and in‐hospital mortality (OR: 2.434, CI: 2.323 ‐ 2.55, p <0.001), when controlling for admission age, SAH severity, and other significant comorbidities. Conclusion The findings of this national database evaluation reveal a significant association between AKI and adverse outcomes in patients with aneurysmal SAH. Specifically, the study highlights a strong correlation between AKI and heightened complication rates, poor functional outcome, extended hospital stays, and elevated mortality rates. These results emphasize the importance of early detection and proactive management of AKI in SAH patients to improve their overall prognosis and enhance their chances of recovery.https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.022 |
| spellingShingle | Galadu Subah Lee Hecht Bridget Nolan Aiden Lui Anaz Uddin Christina Ng Nitesh Damodara Chirag Gandhi Fawaz Al‐Mufti Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic Implications Stroke: Vascular and Interventional Neurology |
| title | Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic Implications |
| title_full | Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic Implications |
| title_fullStr | Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic Implications |
| title_full_unstemmed | Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic Implications |
| title_short | Abstract 022: Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring its Clinical Significance and Prognostic Implications |
| title_sort | abstract 022 acute kidney injury in subarachnoid hemorrhage exploring its clinical significance and prognostic implications |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.03.suppl_2.022 |
| work_keys_str_mv | AT galadusubah abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT leehecht abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT bridgetnolan abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT aidenlui abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT anazuddin abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT christinang abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT niteshdamodara abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT chiraggandhi abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications AT fawazalmufti abstract022acutekidneyinjuryinsubarachnoidhemorrhageexploringitsclinicalsignificanceandprognosticimplications |