Adverse Outcomes Higher in CKD With Hospital-acquired Complications

HealthDay News — Preventable hospital-acquired complications (HACs) are associated with increased risk of adverse outcomes, especially among patients with chronic kidney disease (CKD), according to a study published in the Clinical Journal of the American Society of Nephrology.

Babak Bohlouli, from the University of Alberta in Canada, and colleagues examined the correlation of preventable HACs with mortality, length of stay (LOS), and readmission among adults. Data were included for 536,549 hospitalizations, including 45,733 with CKD.

The researchers found that in patients with CKD and at least one preventable HAC, the adjusted odds ratios of mortality during index hospitalization and from hospital discharge to 90 days were 4.67 (95% confidence interval [CI], 4.17 to 5.22) and 1.08 (95% CI, 0.94 to 1.25), respectively. In patients with one or more preventable HAC, the median incremental LOS was 9.86 days. The odds ratio for readmission was 1.24 (95% CI, 1.15 to 1.34) with preventable HAC. Relative to patients without CKD or preventable HAC, the odds ratios for mortality during index hospitalization were 2.22 (95% CI, 1.69 to 2.94), 5.26 (95% CI, 4.98 to 5.55), and 9.56 (95% CI, 7.23 to 12.56), respectively, for patients with CKD with no HAC, without CKD with HACs, and with CKD and HACs.

“Preventable HACs are associated with higher mortality, incremental LOS, and greater risk of readmission, especially in people with CKD,” the researchers write.

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Bohlouli B, Jackson TJ, Tonelli M, Hemmelgarn B, Klarenbach S. Adverse outcomes associated with preventable complications in hospitalized patients with CKD. Clin J Am Soc Nephrol. 2017;12:799-806. doi: 10.2215/CJN.09410916