Yang Chien-Wen, Li Si, Dong Yishan, Paliwal Nitpriya, Wang Yichen
Renal Electrolyte and Hypertension Division, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104, USA.
Department of Internal Medicine, Wright Center for Graduate Medical Education, 501 S Washington Ave, Scranton, PA 18505, USA.
J Clin Med. 2021 May 1;10(9):1950. doi: 10.3390/jcm10091950.
Currently, no large, nationwide studies have been conducted to analyze the demographic factors, underlying comorbidities, clinical outcomes, and health care utilization in rhabdomyolysis patients with and without acute kidney injury (AKI).
We queried the National Inpatient Sample of Healthcare Cost and Utilization Project (HCUP) with patients with rhabdomyolysis from 2016 to 2018. The chi-squared test was used to compare categorical variables, and the adjusted Wald test was employed to compare quantitative variables. The logistic regression model was applied to calculate adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) to estimate the impact of AKI on outcomes in patients with rhabdomyolysis.
Among 111,085 rhabdomyolysis-related hospitalizations, a higher prevalence of AKI was noticed in older patients (mean age ± SD, 58.2 ± 21.6 vs. 53.8 ± 22.2), Medicare insurance (48.5% vs. 43.2%), and patients with a higher Charlson Comorbidity Index score (CCI 3-5, 15.1% vs. 5.5%). AKI was found to be independently associated with higher mortality (adjusted odds ratio [aOR] 3.33, 95% CI 2.33-4.75), longer hospital stays (adjusted difference 1.17 days, 95% CI: 1.00-1.34), and higher cost of hospital stay (adjusted difference $11,315.05, 95% CI: $9493.02-$13,137.07).
AKI in patients hospitalized with rhabdomyolysis is related to adverse clinical outcomes and significant economic and survival burden.
目前，尚未开展大规模的全国性研究来分析伴有和不伴有急性肾损伤（AKI）的横纹肌溶解症患者的人口统计学因素、潜在合并症、临床结局及医疗保健利用情况。
我们查询了2016年至2018年医疗成本和利用项目（HCUP）的全国住院患者样本中的横纹肌溶解症患者。采用卡方检验比较分类变量，采用校正Wald检验比较定量变量。应用逻辑回归模型计算校正比值比（OR）及95%置信区间（95%CI），以评估AKI对横纹肌溶解症患者结局的影响。
在111,085例与横纹肌溶解症相关的住院病例中，老年患者（平均年龄±标准差，58.2±21.6岁 vs. 53.8±22.2岁）、医疗保险患者（48.5% vs. 43.2%）以及Charlson合并症指数评分较高（CCI 3 - 5，15.1% vs. 5.5%）的患者中AKI患病率更高。发现AKI与较高的死亡率（校正比值比[aOR] 3.33，95%CI 2.33 - 4.75）、更长的住院时间（校正差异1.17天，95%CI：1.00 - 1.34）以及更高的住院费用（校正差异11,315.05美元，95%CI：9493.02 - 13,137.07美元）独立相关。
因横纹肌溶解症住院患者的AKI与不良临床结局以及显著的经济和生存负担相关。
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