P0593incidence and Impact of Acute Kidney Injury (Aki) in a Third Level Hospital

Abstract

Background and Aims The AKI index is increasing, reaching 22% in hospitalized patients. Despite the negative impact it implies, in daily practice its management remains suboptimal and there is little awareness of the problem. Aims: Know the incidence of AKI in a Third-level hospital; its impact on mortality, average stay and associated costs. Method Descriptive cross-sectional study of data extracted from CMBDA corresponding to a third level hospital during 2016-17. We analyze: hospitalization episodes, referral assistance units, AKI episodes at discharge, stays and exitus. To calculate associated costs, we use as reference the costs/day-hospitalization per Healthcare Unit in SAS according to BOJA-Number 218 (14nov2016). We compare groups according to presence/no AKI. Limitations: These data may be underestimated since the diagnosis of AKI may be present and not reported upon discharge; Nor do we include dialysis costs. Results 56,816 revenues were produced; 3,589 reported AKI (incidence: 6.31%). Patients with AKI add 42,801 stays; Average stay of 18.4 days in 2016, 16.4 in 2017, compared to 6.6 and 8.7 days respectively when FRA is not associated (p <0.01). The estimated costs associated with the FRA were 22,815,558 euros, with a cost / episode of 6023 euros, compared to 3523 euros in patients without FRA. The overall associated mortality AKI was 23.2% vs 11% in the rest (p <0.01). Average stay, costs and mortality vary widely according to the Assistance Units, the impact being especially worrying in Surgical Units (table). Conclusion The incidence of AKI in our hospital lower than that referred to in the literature probably responds to inadequate registration in discharge reports. Despite the limitations, our data demonstrate the impact of the diagnosis of AKI in hospitalized patients, doubling the average stay, costs and mortality. These differences are accentuated in some Assistance Units, being especially alarming in Surgical Units.