Recent results from Massachusetts General Hospital published
Patients hospitalized with acute kidney injury (AKI) or acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were at higher risk of 30- and 90-day readmission, according to a paper published in BMC Nephrology. Investigators from Massachusetts General Hospital in Boston retrospectively studied more than 350,000 patients hospitalized with AECOPD in order to determine the link between AKI and readmission risks in this population. Prior studies have indicated a relationship between AKI and AECOPD, but the study authors wrote that there is a gap in the literature for longitudinal studies. The patients in the analysis were hospitalized adults over the age of 40 years with a principal discharge diagnosis of COPD. The investigators collected data about the patients’ sex, age, race/ethnicity, primary insurance type, estimated household income, patient residence, diagnosis and procedure codes, comorbidities, hospital course, and disposition.
Most of the patients were older (median age: 71 years), male (42%), and white (74%), the study authors determined. During index hospitalization, 7% of patients had a new diagnosis of AKI. The study authors noted that the AKI group was more likely to be older and male. In total, 16% of patients had at least 1 readmission within 30 days after their primary hospitalization, the investigators found. After 90 days of index hospitalization, 31% of patients had at least 1 readmission, they added. However, for the AKI patients, the investigators noted a significant difference among all-cause 30- and 90-day readmission rates compared to the overall group. The AKI group had a significantly higher risk of 30-day readmission and a 90-day readmission, the study authors said. This remained true when the investigators further broke the data down to include patients aged 65 years or older only, women only, or patients without chronic kidney disease. After the study authors stratified the data by dialysis use, the AKI group had higher 30- and 90-day readmission rates compared to those without AKI. The most frequent cause for readmission among patients without AKI was COPD, followed by pneumonia, respiratory failure, and asthma. The study authors learned that the AKI patients were more likely to be readmitted due to non-respiratory diseases, such as sepsis, acute renal failure, or congestive heart failure.
SOURCE: AJMC
