Abstract
Introduction: Acute kidney injury (AKI) is an important risk factor associated with adverse outcomes in cardiovascular illnesses; more importantly, myocardial infarction (MI). This study describes the Trends and in-hospital outcomes, and independent predictors of Acute Kidney Injury (AKI) in patients admitted for Myocardial infarction with Percutaneous Coronary Intervention (PCI). Methods: This was a retrospective study using records from the 2016-2020 National In-patient Database (NIS). We identified patients who were admitted for the management of an MI who had a PCI procedure and developed an AKI, evaluated their associated socio-demographic and comorbid factors using ICD-10 codes. We utilized the chi-square test to compare baseline characteristics between our populations with and without AKI and multivariate logistic regression to identify outcomes. Results: 1,551,630 patients admitted for an MI and PCI with 15% having an AKI compared to 85% without AKI. Our population with AKI had a mean age of 69 years on admission and were more likely to be whites. A higher percentage were males. Our subpopulation was more likely to have HF, atrial fibrillation, COPD, prior history of CABG, obesity, CKD, Charlson comorbidity index (CCI) ≥ 3 and anemia. The independent Predictors of developing AKI in our cohort included: CKD, cardiogenic shock, cardiac arrest, CCI of ≥3 and HF. The development of AKI was associated with higher in-hospital mortality rates (aOR: 2.84, CI: 2.7 - 3.02, p<0.001), longer mean Length of Stay (7.1 vs 3.0 days) and higher hospital costs ($183,785.8 vs $101,291.2). We noted an increasing trend in the rates of patients who had an AKI from about 13.5% in 2016 to 16.5% in 2020. Conclusions: AKI is strongly associated with worse hospital outcomes in patients admitted for MI and PCI. A more concise look into preventive measures is recommended to minimize these outcomes.
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