Impact of Acute Kidney Injury in Hospitalizations with Non-Variceal Upper Gastrointestinal Bleeding

Abstract

Abstract Background: Acute Kidney Injury (AKI) is a commonly occurring comorbidity in hospitalized patients. Our objective was to identify the role of AKI in relation to the morbidity and mortality in Non-Variceal Upper Gastrointestinal Bleeding (NVUGIB) patients. Study: Nationwide Inpatient Sample (NIS) database was used from the year 2000 to 2014 and queried for patients with NVUGIB. Patients were further stratified with and without the presence of concomitant AKI. Weighed multivariate regression analyses were performed to determine the final conclusions of the study. Results: Total of 4,889,410 patients with NVUGIB were identified during the study period. AKI was a comorbid condition in 6.37% of all patients. Incidence of AKI in NVUGIB patients has increased over five-fold over the study period. After adjusting for confounders through multivariate regression model, patients in the AKI group had higher odds of mortality (OR 2.84, p < 0.001). Additionally, patients with AKI were more likely to receive blood transfusion (OR 1.30, p < 0.001), had longer length of stay (+ 1.73 days, p < 0.001), had higher hospital charges (+ $16,221, p < 0.001), and had higher disposition to intermediate care facility (OR 1.84, p < 0.001). Conclusions: Incidence of AKI in hospitalized NVUGIB patients has increased dramatically. Interestingly, AKI is also associated with higher morbidity and mortality in NVUGIB patients. Consequently, AKI should be used as a marker for disease severity in hospitalized NVUGIB patients.