Dasta Joseph F, Kane-Gill Sandra
1 Division of Practice and Science, The Ohio State University, Columbus, OH, USA.
2 Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
J Pharm Pract. 2019 Jun;32(3):292-302. doi: 10.1177/0897190019852556.
Acute kidney injury (AKI) develops in 8% to 16% of hospital admissions. These patients exhibit a 4- to 10-fold increase in mortality and prolonged hospital stays. There is a dearth of information on the economics of AKI, especially in critically ill patients whose health-care costs are already high. It is important that pharmacists understand the economic impact of AKI to optimally prevent and treat AKI occurrence, thus reducing total hospital costs. Authors used MEDLINE, PubMed, and Google Scholar searches up to April 2019. Inpatient AKI affects an estimated 498 000 patients in the United States with its annual cost from $4.7 to $24.0 billion. Average patient costs of AKI in the intensive care unit are generally double than those of non-AKI patients. High AKI severity portends a higher cost. Total hospital costs in patients with AKI ranged from $29 700 in cardiac surgery patients to $80 400 in cardiogenic shock. Incremental increases of cost range from $9400 in major surgery patients and up to $81 000 in nonsurviving dialysis patients. The enormity of the clinical and economic impact of AKI should be a call to action by pharmacists to expeditiously select patient-specific therapies to prevent and treat AKI, and thus reduce its economic burden on an already fragile health-care system.
急性肾损伤（AKI）在8%至16%的住院患者中发生。这些患者的死亡率增加了4至10倍，住院时间延长。关于AKI经济学方面的信息匮乏，尤其是在医疗保健成本本就高昂的重症患者中。药剂师了解AKI的经济影响对于最佳地预防和治疗AKI的发生、从而降低医院总成本非常重要。作者检索了截至2019年4月的MEDLINE、PubMed和谷歌学术。在美国，住院AKI估计影响49.8万名患者，其年度成本从47亿美元到240亿美元不等。重症监护病房中AKI患者的平均成本通常是非AKI患者的两倍。AKI严重程度越高，成本越高。AKI患者的医院总成本从心脏手术患者的29700美元到心源性休克患者的80400美元不等。成本的增量增加范围从大手术患者的9400美元到未存活的透析患者的81000美元。AKI临床和经济影响的严重性应促使药剂师采取行动，迅速选择针对患者的疗法来预防和治疗AKI，从而减轻其对本就脆弱的医疗保健系统的经济负担。
