Frailty as a predictor of acute kidney injury in hospitalized elderly patients: A single center, retrospective cohort study

Seon Ha Baek, Sung Woo Lee, Sun Wook Kim, Shin Young Ahn, Mi Yeon Yu, Kwangil Kim, Ho Jun Chin, Ki Young Na, Dong Wan Chae, Sejoong Kim

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Elderly patients have an increased risk for acute kidney injury (AKI). However, few studies have reported on predictors for AKI in geriatric patients. Therefore, we aimed at determining the effect of frailty as a predictor of AKI. Methods: We retrospectively enrolled 533 hospitalized elderly patients (aged ≥ 65 years) who had their creatinine levels measured (≥ 1 measurement) during admission for a period of 1 year (2013) and conducted a comprehensive geriatric assessment (CGA) within 1 year before the index hospitalization. We examined five variables (activity of daily living [ADL] and instrumental ADL dependence, dementia, nutrition, and polypharmacy) from CGA. We categorized the patients into 3 groups according to the tertile of aggregate frailty scores: Group 1, score 1-2; Group 2, score 3-4; Group 3, score 5-8). Results: Fifty-four patients (10.1%) developed AKI (median duration, 4 days). The frailest group (Group 3) showed an increased risk of AKI as compared to Group 1, (hazard ratio [HR] = 3.536, P = 0.002). We found that discriminatory accuracy for AKI improved with the addition of the tertile of aggregate frailty score to covariates (area under the receiver operator characteristics curves [AUROC] 0.641, AUROC 0.739, P = 0.004). Forty-six patients (8.6%) were transferred to nursing facilities and 477 patients (89.5%) were discharged home. The overall 90-day and 1-year mortality for elderly inpatients were 7.9% and 26.3%. The frailest group also demonstrated an increased risk of discharge to nursing facilities, and 90-day and 1-year mortality as compared to Group 1, independent of AKI severity (nursing facilities: odd ratio = 4.843, P = 0.002; 90-day mortality: HR = 6.555, P = 0.002; 1-year mortality: HR = 3.249, P = 0.001). Conclusions: We found that frailty may independently predict the development of AKI and adverse outcomes in geriatric inpatients.

Original languageEnglish
Article numbere0156444
JournalPLoS One
Volume11
Issue number6
DOIs
Publication statusPublished - 2016 Jun 1
Externally publishedYes

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Geriatrics
cohort studies
Acute Kidney Injury
Nursing
Cohort Studies
Retrospective Studies
kidneys
Hazards
nursing homes
Activities of Daily Living
Geriatric Assessment
Mortality
Nutrition
Inpatients
Creatinine
Polypharmacy
dementia
Area Under Curve
Dementia
odds ratio

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Frailty as a predictor of acute kidney injury in hospitalized elderly patients : A single center, retrospective cohort study. / Ha Baek, Seon; Lee, Sung Woo; Kim, Sun Wook; Ahn, Shin Young; Yu, Mi Yeon; Kim, Kwangil; Chin, Ho Jun; Na, Ki Young; Chae, Dong Wan; Kim, Sejoong.

In: PLoS One, Vol. 11, No. 6, e0156444, 01.06.2016.

Research output: Contribution to journalArticle

Ha Baek, Seon ; Lee, Sung Woo ; Kim, Sun Wook ; Ahn, Shin Young ; Yu, Mi Yeon ; Kim, Kwangil ; Chin, Ho Jun ; Na, Ki Young ; Chae, Dong Wan ; Kim, Sejoong. / Frailty as a predictor of acute kidney injury in hospitalized elderly patients : A single center, retrospective cohort study. In: PLoS One. 2016 ; Vol. 11, No. 6.
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AU - Ha Baek, Seon

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AU - Kim, Sun Wook

AU - Ahn, Shin Young

AU - Yu, Mi Yeon

AU - Kim, Kwangil

AU - Chin, Ho Jun

AU - Na, Ki Young

AU - Chae, Dong Wan

AU - Kim, Sejoong

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