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Association between acute kidney injury and neurological outcome or death at 6 months in out-of-hospital cardiac arrest: A prospective, multicenter, observational cohort study

Authors
Oh, Je HyeokLee, Dong HoonCho, In SooYoun, Chun SongLee, Byung KookWee, Jung HeeCha, Kyoung-ChulChae, Minjung KathyShin, JonghwanPark, Kyu NamKim, Won YoungMin, Jin HongCho, Soo HyungJeong, TaeohJang, Tae ChangLee, Jae HoonHan, ChulYou, Je SungLee, Young HwanKim, ChangsunCho, Gyu ChongKim, Su JinLee, Jong-SeokLee, Mi JinKim, InbyungKim, Yong HwanSim, Min SeobLee, Ji HwanKim, GiwoonMoon, Hyung JunKim, Ji HoonJeong, Won JungOh, Joo SukChoi, Seung PillChoi, Wook-Jin
Issue Date
12월-2019
Publisher
W B SAUNDERS CO-ELSEVIER INC
Keywords
Acute kidney injury; Out-of-hospital cardiac arrest; Targeted temperature management; Therapeutic hypothermia; Survival rate
Citation
JOURNAL OF CRITICAL CARE, v.54, pp.197 - 204
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF CRITICAL CARE
Volume
54
Start Page
197
End Page
204
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/61405
DOI
10.1016/j.jcrc.2019.08.029
ISSN
0883-9441
Abstract
Purpose: This study aimed to evaluate the association between acute kidney injury (AKI) and 6 months neurological outcome after out-of-hospital cardiac arrest (OHCA). Materials and methods: Prospective multi-center observational cohort included adult OHCA patients treated with targeted temperature management (TTM) across 20 hospitals in the South Korea between October 2015 and October 2017. The diagnosis of AKI was made using the Kidney Disease: Improving Global Outcomes criteria. The outcome was neurological outcome at 6 months evaluated using the modified Rankin scale (MRS). Results: Among 5676 patients with OHCA, 583 patients were enrolled. AKI developed in 348 (60%) patients. Significantly more non-AKI patients had good neurological outcome at 6 months (MRS 0-3) than AKI patients (134/235 [57%] vs. 69/348 [20%], P < .001). AKI was associated with poor neurological outcome at six months in multivariate logistic regression analysis (adjusted odds ratio: 0.206 [95% confidence interval: 0.099-0.426], P < .001]). Cox regression analysis with time-varying covariate of AKI showed that patients with AKI had a higher risk of death than those without AKI (hazard ratio: 2.223; 95% confidence interval: 1.630-3.030, P < .001). Conclusions: AKI is associated with poor neurological outcome (MRS 4-6) at 6 months in OHCA patients treated with TTM. (C) 2019 Elsevier Inc. All rights reserved.
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