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

Je Hyeok Oh, Dong Hoon Lee, In Soo Cho, Chun Song Youn, Byung Kook Lee, Jung Hee Wee, Kyoung Chul Cha, Minjung Kathy Chae, Jong Hwan Shin

Research output: Contribution to journalArticle

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. Trial registration: NCT02827422

Original languageEnglish
Pages (from-to)197-204
Number of pages8
JournalJournal of Critical Care
Volume54
DOIs
StatePublished - 1 Dec 2019

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Out-of-Hospital Cardiac Arrest
Acute Kidney Injury
Observational Studies
Cohort Studies
Regression Analysis
Confidence Intervals
Republic of Korea
Temperature
Kidney Diseases
Logistic Models
Odds Ratio
Kidney

Keywords

  • Acute kidney injury
  • Out-of-hospital cardiac arrest
  • Survival rate
  • Targeted temperature management
  • Therapeutic hypothermia

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Oh, Je Hyeok ; Lee, Dong Hoon ; Cho, In Soo ; Youn, Chun Song ; Lee, Byung Kook ; Wee, Jung Hee ; Cha, Kyoung Chul ; Chae, Minjung Kathy ; Shin, Jong Hwan. / 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. In: Journal of Critical Care. 2019 ; Vol. 54. pp. 197-204.
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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. Trial registration: NCT02827422",
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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. / Oh, Je Hyeok; Lee, Dong Hoon; Cho, In Soo; Youn, Chun Song; Lee, Byung Kook; Wee, Jung Hee; Cha, Kyoung Chul; Chae, Minjung Kathy; Shin, Jong Hwan.

In: Journal of Critical Care, Vol. 54, 01.12.2019, p. 197-204.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between acute kidney injury and neurological outcome or death at 6 months in out-of-hospital cardiac arrest

T2 - A prospective, multicenter, observational cohort study

AU - Oh, Je Hyeok

AU - Lee, Dong Hoon

AU - Cho, In Soo

AU - Youn, Chun Song

AU - Lee, Byung Kook

AU - Wee, Jung Hee

AU - Cha, Kyoung Chul

AU - Chae, Minjung Kathy

AU - Shin, Jong Hwan

PY - 2019/12/1

Y1 - 2019/12/1

N2 - 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. Trial registration: NCT02827422

AB - 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. Trial registration: NCT02827422

KW - Acute kidney injury

KW - Out-of-hospital cardiac arrest

KW - Survival rate

KW - Targeted temperature management

KW - Therapeutic hypothermia

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DO - 10.1016/j.jcrc.2019.08.029

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