Background: Acute kidney injury (AKI) is a common clinical problem. Studies have documented the incidence of\nAKI in a variety of populations but to date we do not believe the real incidence of AKI has been accurately\ndocumented in a district general hospital setting.\nThe aim here was to describe the detected incidence of AKI in a typical general hospital setting in an unselected\npopulation, and describe associated short and long-term outcomes.\nMethods: A retrospective observational database study from secondary care in East Kent (adult catchment\npopulation of 582,300). All adult patients (18 years or over) admitted between 1st February 2009 and 31st July 2009,\nwere included. Patients receiving chronic renal replacement therapy (RRT), maternity and day case admissions were\nexcluded. AKI was defined by the acute kidney injury network (AKIN) criteria. A time dependent risk analysis with\nlogistic regression and Cox regression was used for the analysis of in-hospital mortality and survival.\nResults: The incidence of AKI in the 6 month period was 15,325 pmp/yr (adults) (69% AKIN1, 18% AKIN2 and 13%\nAKIN3). In-hospital mortality, length of stay and ITU utilisation all increased with severity of AKI. Patients with AKI\nhad an increase in care on discharge and an increase in hospital readmission within 30 days.\nConclusions: This data comes closer to the real incidence and outcomes of AKI managed in-hospital than any\nstudy published in the literature to date. Fifteen percent of all admissions sustained an episode of AKI with\nincreased subsequent short and long term morbidity and mortality, even in those with AKIN1. This confers\nan increased burden and cost to the healthcare economy, which can now be quantified. These results will\nfurnish a baseline for quality improvement projects aimed at early identification, improved management, and\nwhere possible prevention, of AKI.
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