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Acute renal failure worsens in-hospital outcomes in patients with intracerebral hemorrhage.
J Stroke Cerebrovasc Dis. 2015 Apr; 24(4):789-94.JS

Abstract

BACKGROUND

Occurrence of acute renal failure (ARF) is more common in patients with intracerebral hemorrhage (ICH) compared with those with other stroke subtypes. We sought to determine the frequency and effect of ARF on in-hospital outcomes of patients with ICH.

METHODS

We analyzed data from all patients admitted to the United States' hospitals between 2005 and 2011 with the primary discharge diagnosis of ICH and secondary diagnosis of ARF. The associations of ARF with mortality and discharge outcomes in ICH patients were analyzed after adjusting for potential confounders using logistic regression analyses.

RESULTS

Of the 614,454 patients admitted with ICH, 41,694 (6.8%) had ARF. In-hospital dialysis was required in 700 (1.7%) patients. ICH patients with ARF had higher rates of moderate-to-severe disability (49.5% versus 44.2%; P < .0001) and in-hospital mortality (28.7% versus 22.4%; P < .0001) compared with those without ARF. After adjusting for age, gender, and potential confounders defined as statistically significant variables on univariate analysis, ICH patients with ARF had higher odds of moderate-to-severe disability (odds ratio [OR] 1.2; 95% confidence interval [CI], 1.1-1.3; P < .0001) and death (OR, 1.5; 95% CI, 1.4-1.6; P < .0001). The rates of moderate-to-severe disability and death were 37.5% and 50.2% among those who required dialysis, respectively.

CONCLUSIONS

In patients with ICH, ARF is associated with significantly higher rates of in-hospital mortality and moderate-to-severe disability at the time of discharge.

Authors+Show Affiliations

Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, Ohio. Electronic address: fahadsaeed20@gmail.com.Ochsner Clinic Foundation and Ochsner Neuroscience Institute, New Orleans, Louisiana.Integris Southwest Hospital, Oklahoma.Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25680664

Citation

Saeed, Fahad, et al. "Acute Renal Failure Worsens In-hospital Outcomes in Patients With Intracerebral Hemorrhage." Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, vol. 24, no. 4, 2015, pp. 789-94.
Saeed F, Adil MM, Piracha BH, et al. Acute renal failure worsens in-hospital outcomes in patients with intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2015;24(4):789-94.
Saeed, F., Adil, M. M., Piracha, B. H., & Qureshi, A. I. (2015). Acute renal failure worsens in-hospital outcomes in patients with intracerebral hemorrhage. Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association, 24(4), 789-94. https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.11.012
Saeed F, et al. Acute Renal Failure Worsens In-hospital Outcomes in Patients With Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis. 2015;24(4):789-94. PubMed PMID: 25680664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute renal failure worsens in-hospital outcomes in patients with intracerebral hemorrhage. AU - Saeed,Fahad, AU - Adil,Malik M, AU - Piracha,Bilal Hussain, AU - Qureshi,Adnan I, Y1 - 2015/02/11/ PY - 2014/08/11/received PY - 2014/11/06/revised PY - 2014/11/14/accepted PY - 2015/2/15/entrez PY - 2015/2/15/pubmed PY - 2015/12/19/medline KW - Acute renal failure KW - dialysis KW - disability KW - intracerebral hemorrhage KW - mortality SP - 789 EP - 94 JF - Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association JO - J Stroke Cerebrovasc Dis VL - 24 IS - 4 N2 - BACKGROUND: Occurrence of acute renal failure (ARF) is more common in patients with intracerebral hemorrhage (ICH) compared with those with other stroke subtypes. We sought to determine the frequency and effect of ARF on in-hospital outcomes of patients with ICH. METHODS: We analyzed data from all patients admitted to the United States' hospitals between 2005 and 2011 with the primary discharge diagnosis of ICH and secondary diagnosis of ARF. The associations of ARF with mortality and discharge outcomes in ICH patients were analyzed after adjusting for potential confounders using logistic regression analyses. RESULTS: Of the 614,454 patients admitted with ICH, 41,694 (6.8%) had ARF. In-hospital dialysis was required in 700 (1.7%) patients. ICH patients with ARF had higher rates of moderate-to-severe disability (49.5% versus 44.2%; P < .0001) and in-hospital mortality (28.7% versus 22.4%; P < .0001) compared with those without ARF. After adjusting for age, gender, and potential confounders defined as statistically significant variables on univariate analysis, ICH patients with ARF had higher odds of moderate-to-severe disability (odds ratio [OR] 1.2; 95% confidence interval [CI], 1.1-1.3; P < .0001) and death (OR, 1.5; 95% CI, 1.4-1.6; P < .0001). The rates of moderate-to-severe disability and death were 37.5% and 50.2% among those who required dialysis, respectively. CONCLUSIONS: In patients with ICH, ARF is associated with significantly higher rates of in-hospital mortality and moderate-to-severe disability at the time of discharge. SN - 1532-8511 UR - https://www.unboundmedicine.com/medline/citation/25680664/Acute_renal_failure_worsens_in_hospital_outcomes_in_patients_with_intracerebral_hemorrhage_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1052-3057(14)00570-9 DB - PRIME DP - Unbound Medicine ER -