Worse Outcome for Discharge From ER With Acute Kidney Injury
FRIDAY, July 21, 2017 -- Patients with an emergency department discharge with acute kidney injury have increased mortality compared to those with no acute kidney injury, according to a study published online July 20 in the Clinical Journal of the American Society of Nephrology.
Rey R. Acedillo, M.D., from the London Health Sciences Center in Canada, and colleagues conducted a population-based retrospective cohort study of 6,346 patients aged 40 years or older discharged from the emergency department with acute kidney injury. Propensity score methods were used to compare all-cause mortality with two referent groups. A total of 4,379 discharged patients were matched with 4,379 patients hospitalized from the emergency department with similar stage of acute kidney injury; 6,188 discharged patients were matched to 6,188 patients discharged home from the emergency department with no acute kidney injury.
The researchers found that there was lower mortality for an emergency department discharge versus hospitalization with acute kidney injury (3 versus 12 percent; relative risk, 0.3). Higher mortality was seen in association with an emergency department discharge with acute kidney injury versus no acute kidney injury (2 versus 1 percent; relative risk, 1.6).
"Patients discharged home from the emergency department with acute kidney injury are at risk of poor 30-day outcomes," the authors write. "A better understanding of care in this at-risk population is warranted, as is testing strategies to improve care."
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Posted: July 2017