Abstract 6985: Real-World Incidence and Factors That Contributes to the Development of Acute Kidney Injury in Patients Receiving Impella for Hemodynamic Support in a Community Based Health Care System

Abstract

Introduction: Impella is a peripherally inserted ventricular assist device used for providing hemodynamic support in patients with cardiogenic shock and/or high risk percutaneous coronary interventions (PCI). The aim of the study was to examine the incidence and factors that can impact acute kidney injury (AKI) in a real world, community-based patient population. Methods: A retrospective observational study was conducted on patients with an Impella placed between January 2015- March 2020 at three hospitals within the Geisinger Health Care System. Results: Of the ninety-nine patients identified, 58 patients (58.3%) developed AKI. In those who had Impella placed electively (n=15), 3 patients (20%) developed AKI. In the urgent group (n=35), 9 patients (25.8%) developed AKI. In the emergent group (n=28), 12 patients (42.9%) developed AKI and in the salvage group (n=20), 8 patients (40%) had AKI. The acuity of the procedure did not significantly impact the subsequent development of AKI (p = 0.38). Chronic kidney (CKD) was present in 35 patients (35.4%) in the group and 15 (42.9%) developed AKI. In the 64 patients without CKD, 17 patients (26.6%) had AKI. The difference among the two group was not significant (p = .097). Patients with higher BMI had a lower likelihood of developing AKI compared to the lower BMI patients (p = .001). Patients with a longer duration of Impella implantation had a lower incidence of AKI (p = .001). Conclusions: AKI is a common complication associated with Impella placement, but its development does not appear to be related to the acuity of the procedure. 2. In the current study, the presence of CKD was not a risk factor for developing AKI. 3. Patient with higher BMI and longer duration of Impella had lower likelihood to develop AKI.