Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrest
Background: Comprehensive studies about renal-function changes in the context of out-of-hospital cardiac arrest (OHCA) have been lacking. Therefore, we investigated the impact of renal function on clinical outcomes among patients with OHCA. Method: This retrospective cohort study enrolled consecutiv...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425000189 |
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| author | Hao-Wei Lee Ming-Jen Kuo Pai-Feng Hsu I-Hsin Lee Chih-Yu Yang Teh-Fu Hsu Chorng-Kuang How Yenn-Jiang Lin Chin-Chou Huang |
| author_facet | Hao-Wei Lee Ming-Jen Kuo Pai-Feng Hsu I-Hsin Lee Chih-Yu Yang Teh-Fu Hsu Chorng-Kuang How Yenn-Jiang Lin Chin-Chou Huang |
| author_sort | Hao-Wei Lee |
| collection | DOAJ |
| description | Background: Comprehensive studies about renal-function changes in the context of out-of-hospital cardiac arrest (OHCA) have been lacking. Therefore, we investigated the impact of renal function on clinical outcomes among patients with OHCA. Method: This retrospective cohort study enrolled consecutive patients with OHCA between June 2017 and December 2021. Acute kidney injury (AKI) was defined based on the “Kidney Disease: Improving Global Outcomes (KDIGO)” guidelines. AKI recovery was defined as a decrease in serum creatinine below the level determined in the definition of AKI. Clinical outcomes included neurological outcomes and all-cause mortality. Result: A total of 258 patients were enrolled, including 35 patients with underlying end-stage renal disease (ESRD). Among patients without ESRD, 82.5% developed AKI, of which 31.0% achieved AKI recovery, while 61.0% were discharged with impaired renal function. Multivariable analysis using regression models revealed that unfavorable neurological outcomes at discharge and higher mortality at 2 years were associated with AKI (odds ratio [OR] 7.684, 95% confidence interval (CI) 2.683–22.010, P < 0.001; hazard ratio [HR] 2.159, 95% CI 1.272–3.664, P = 0.004), AKI without recovery (OR 5.275, 95% CI 2.049–13.583, P < 0.001; HR 5.470, 95% CI 3.304–9.862, P < 0.001), and impaired pre-discharge renal function (OR 3.164, 95% CI 1.442–6.940, P = 0.004; HR 2.876, 95% CI 1.861–4.443, P < 0.001). Compared to those without ESRD, patients with underlying ESRD had similar neurological outcomes and mortality. Conclusion: AKI, AKI without recovery, and impaired pre-discharge renal function were significantly correlated with worse clinical outcomes in OHCA among patients without ESRD, while underlying ESRD did not lead to worse clinical outcomes. |
| format | Article |
| id | doaj-art-b61cee27f1554bab8f74d295d1d72ed5 |
| institution | Kabale University |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-b61cee27f1554bab8f74d295d1d72ed52025-02-09T05:01:30ZengElsevierResuscitation Plus2666-52042025-03-0122100881Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrestHao-Wei Lee0Ming-Jen Kuo1Pai-Feng Hsu2I-Hsin Lee3Chih-Yu Yang4Teh-Fu Hsu5Chorng-Kuang How6Yenn-Jiang Lin7Chin-Chou Huang8Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; General Cardiology, Cardiovascular Center, Cathay General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Cardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Emergency, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, TaiwanSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Emergency, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Emergency, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Pharmacology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Corresponding author at: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.Background: Comprehensive studies about renal-function changes in the context of out-of-hospital cardiac arrest (OHCA) have been lacking. Therefore, we investigated the impact of renal function on clinical outcomes among patients with OHCA. Method: This retrospective cohort study enrolled consecutive patients with OHCA between June 2017 and December 2021. Acute kidney injury (AKI) was defined based on the “Kidney Disease: Improving Global Outcomes (KDIGO)” guidelines. AKI recovery was defined as a decrease in serum creatinine below the level determined in the definition of AKI. Clinical outcomes included neurological outcomes and all-cause mortality. Result: A total of 258 patients were enrolled, including 35 patients with underlying end-stage renal disease (ESRD). Among patients without ESRD, 82.5% developed AKI, of which 31.0% achieved AKI recovery, while 61.0% were discharged with impaired renal function. Multivariable analysis using regression models revealed that unfavorable neurological outcomes at discharge and higher mortality at 2 years were associated with AKI (odds ratio [OR] 7.684, 95% confidence interval (CI) 2.683–22.010, P < 0.001; hazard ratio [HR] 2.159, 95% CI 1.272–3.664, P = 0.004), AKI without recovery (OR 5.275, 95% CI 2.049–13.583, P < 0.001; HR 5.470, 95% CI 3.304–9.862, P < 0.001), and impaired pre-discharge renal function (OR 3.164, 95% CI 1.442–6.940, P = 0.004; HR 2.876, 95% CI 1.861–4.443, P < 0.001). Compared to those without ESRD, patients with underlying ESRD had similar neurological outcomes and mortality. Conclusion: AKI, AKI without recovery, and impaired pre-discharge renal function were significantly correlated with worse clinical outcomes in OHCA among patients without ESRD, while underlying ESRD did not lead to worse clinical outcomes.http://www.sciencedirect.com/science/article/pii/S2666520425000189Acute kidney injuryEnd-stage renal diseaseOut-of-hospital cardiac arrestRenal function |
| spellingShingle | Hao-Wei Lee Ming-Jen Kuo Pai-Feng Hsu I-Hsin Lee Chih-Yu Yang Teh-Fu Hsu Chorng-Kuang How Yenn-Jiang Lin Chin-Chou Huang Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrest Resuscitation Plus Acute kidney injury End-stage renal disease Out-of-hospital cardiac arrest Renal function |
| title | Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrest |
| title_full | Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrest |
| title_fullStr | Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrest |
| title_full_unstemmed | Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrest |
| title_short | Renal function and clinical outcomes in survivors of out-of-hospital cardiac arrest |
| title_sort | renal function and clinical outcomes in survivors of out of hospital cardiac arrest |
| topic | Acute kidney injury End-stage renal disease Out-of-hospital cardiac arrest Renal function |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425000189 |
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