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J Support Oncol. 2011 Jul-Aug;9(4):149-55.

Costs and outcomes of acute kidney injury in critically ill patients with cancer.

Author information

1
Department of General Internal Medicine, Section of Nephrology, The University of Texas M.D. Anderson Cancer Center, PO Box 301402, FCT 13.6068, Houston, TX, 77230-1402, USA. alahoti@mdanderson.org

Abstract

BACKGROUND:

Acute kidney injury (AKI) is a common complication in critically ill patients with cancer. The RIFLE criteria define three levels of AKI based on the percent increase in serum creatinine (Scr) from baseline: risk (> or = 50%), injury (> or = 100%), and failure (> or = 200% or requiring dialysis). The utility of the RIFLE criteria in critically ill patients with cancer is not known.

OBJECTIVE:

To examine the incidence, outcomes, and costs associated with AKI in critically ill patients with cancer.

METHODS:

We retrospectively analyzed all patients admitted to a single-center ICU over a 13-month period with a baseline Scr < or = 1.5 mg/dL (n = 2,398). Kaplan-Meier estimates for survival by RIFLE category were calculated. Logistic regression was used to determine the association of AKI on 60-day mortality. A log-linear regression model was used for economic analysis. Costs were assessed by hospital charges from the provider's perspective.

RESULTS:

For the risk, injury, and failure categories of AKI, incidence rates were 6%, 2.8%, and 3.7%; 60-day survival estimates were 62%, 45%, and 14%; and adjusted odds ratios for 60-day mortality were 2.3, 3, and 14.3, respectively (P < or = 0.001 compared to patients without AKI). Hematologic malignancy and hematopoietic cell transplant were not associated with mortality in the adjusted analysis. Hospital cost increased by 0.16% per 1% increase in creatinine and by 21% for patients requiring dialysis.

LIMITATIONS:

Retrospective analysis. Single-center study. No adjustment by cost-to-charge ratios.

CONCLUSIONS:

AKI is associated with higher mortality and costs in critically ill patients with cancer.

PMID:
21809520
[Indexed for MEDLINE]

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