Factors Of In-hospital Mortality In Patients Research Articles

Seasonal pattern in elderly hospitalized with acute kidney injury: a retrospective nationwide study in Italy

PurposeAcute kidney injury (AKI) frequently complicates hospitalization and is associated with in-hospital mortality (IHM). It has been reported a seasonal trend in different clinical conditions. The aim of this study was to evaluate the possible relationship between seasons of the year and IHM in elderly hospitalized patients with AKI.MethodsWe selected all admissions complicated by AKI between 2000 and 2015 recorded in the Italian National Hospital Database. ICD-9-CM code 584.xx identified subjects with age ≥ 65 years and age, sex, comorbidity burden, need of dialysis treatment and IHM were compared in hospitalizations recorded during the four seasons. Moreover, we plotted the AKI observed/expected ratio and percentage of mortality during the study period.ResultsWe evaluated 759,720 AKI hospitalizations (mean age 80.5 ± 7.8 years, 52.2% males). Patients hospitalized with AKI during winter months had higher age, prevalence of dialysis-dependent AKI, and number of deceased patients. In whole population IHM was higher in winter and lower in summer, while the AKI observed/expected ratio demonstrated two peaks, one in summer and one in winter. Logistic regression analysis demonstrated that parameters such as age, autumn, winter, comorbidity burden were positively associated with IHM.ConclusionWe conclude that a seasonality exists in AKI, however, relationship between seasons and AKI could vary depending on the aspects considered. Both autumn and winter months are independent risk factors for IHM in patients with AKI regardless of age, sex and comorbidity burden. On the contrary, summer time reduces the risk of death during hospitalizations with AKI.

1246-P: Risk Factors Associated with In-Hospital Mortality In Patients with COVID-and Type 2 Diabetes in Chile

Background: Risk factors associated with in-hospital mortality (IHM) have been identified among patients with T2D hospitalized for COVID-19, including male sex, elderly, impaired renal function and poor metabolic control. At a local setting, data regarding the impact of these variables are lacking. Aim: To assess the association between risk factors and IHM in patients with T2D admitted for COVID-19. Methodology: This is a descriptive observational study. We used electronic health records data provided by a tertiary-level hospital in Chile, between April to July 2020. Included demographic, clinical, and laboratory variables of inpatients with T2D and a positive PCR for SARS-CoV-2. Multiple logistic regression analysis was used to identify predictors of IHM. Results: We identified 200 individuals. Mean age was 63.0±13.6 years, 59.5% (n=119) were adults aged ≥60 years and 58% were male (n=116) . Mean admission glycemia and A1C were 216±120 mg/dl and 8.8±2.4%, respectively. Median admission serum creatinine was 0.8 mg/dL (p25-p75: 0.6-1.1 mg/dL) . A total of 38 patients (19%) died during hospitalization, of these 26.3% (n=10) died within the first week, 63.2% (n=24) between 2-4 weeks, and 10.5% (n=4) after the first month. Age ≥60 years (OR 2.9, 95%CI [1.3-6.7], p=0.01) and elevated admission serum creatinine (OR 1.28, 95%CI [1.04-1.58], p=0.01) were identified as independent predictors of IHM in multiple logistic regression analysis. No association was identified for sex, admission glycemia or A1C, however 37% of our sample lacked an A1C measurement, which could imply a bias. Conclusion: Our study confirms that older age and elevated admission serum creatinine are risk factors for IHM in patients with T2D hospitalized for COVID-19. These results reinforce the importance of identifying risk factors to improve outcomes related to COVID-during in-hospital stay of patients with T2D. We must promote A1C measurement at admission for all patients with diabetes or hyperglycemia. Disclosure O.Vargas: None. P.Poblete: None. E.Vega: None. L.Toro: None. P.C.Gomez: None. A.Villarroel: None. M.G.Sanzana gonzalez: None. C.Vargas: None.

Comorbidities and risk of mortality among hospitalized patients with idiopathic pulmonary fibrosis in Spain from 2002 to 2014.

To describe and compare the comorbid conditions, the in-hospital mortality (IHM) and the length of hospital stay (LOHS) among idiopathic pulmonary fibrosis (IPF) patients and non-IPF-matched patients hospitalized in Spain. We assess the performance of the Charlson Comorbidity Index[CCI] and the Elixhauser Comorbidity Index[ECI] to predict IHM in IPF and we identify the specific predictive factors of IHM in patients suffering IPF. We identified patients with IPF hospitalized in years 2002, 2006, 2010 and 2014. Cases of IPF were matched with non-IPF controls by sex, age, province of residence and year. Data were collected from the Spanish National Hospital Discharge Database. We identified 10,285 hospitalizations with IPF, evidencing an increase in the number of IPF patients from 2002 to 2014. Overtime the prevalence of comorbidities included in the CCI significantly increased in patients with IPF, exception made of myocardial infarction and dementia. The prevalence of comorbidities included in the ECI, except paralysis and peptic ulcer disease excluding bleeding, increased significantly overtime. LOHS was longer among IPF patients than non-IPF controls and decreased significantly from 2002 to 2014. IHM was significantly higher in patients with IPF (adjustedOR 1.97; 95%CI 1.77-2.19). Area under the ROC curves showed that ECI model had a better performance to predict IHM than CCI. The incidence of hospitalizations for IPF increased significantly from 2002 to 2014. We observed an increase overtime of most of the comorbidities included in CCI and ECI. LOHS and IHM were higher in patients with IPF than in non-IPF controls.