Heart failure (HF) contributes to a high rate of hospitalizations. Acute kidney injury
(AKI), with or without chronic kidney disease (CKD), is a common complication in patients
with HF. The link between AKI and the risk for readmission for repeat episodes of
HF is not well studied. In this study, 6,535 patients discharged with primary diagnoses
of HF derived from a statewide inpatient database were examined. The association between
AKI, with and without CKD, and risk for 30-day readmission with HF was assessed. Logistic
regression was used to test the relations between predictor variables and outcomes.
The mean age was 73.8 ± 14.6 years, and 51% of patients (n = 3,351) were women. AKI
occurred in 6.5% of patients during the index hospitalization, whereas 16% had CKD.
Nine hundred seventy-seven patients (15%) required readmission within 30 days for
HF. Index hospital mortality was 1.7% in those without AKI or CKD compared to 11%
and 13% in those with AKI without and with CKD, respectively (p <0.0001). Patients
with AKI had a 30-day readmission rate of 21%, compared to 14% in those without AKI
(p <0.0001). On multivariate analysis, AKI without CKD was associated with the highest
risk for readmission (odds ratio 1.81, 95% confidence interval 1.35 to 2.39) compared
to those with neither of the 2 diagnoses. In conclusion, patients with HF who have
AKI experience a high rate of 30-day readmission for repeat episodes of HF. Reducing
the risk for AKI, and follow-up monitoring after AKI, may improve care and reduce
health care costs in patients with HF.
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Article Info
Publication History
Published online: March 01, 2012
Accepted:
January 12,
2012
Received in revised form:
January 12,
2012
Received:
December 12,
2011
Identification
Copyright
Published by Elsevier Inc.
