Acute kidney injury after in-hospital cardiac arrest in a predominant internal medicine and cardiology patient population: incidence, risk factors, and impact on survival

Figures & data

Figure 1. Percentage of AKI-incidence after IHCA, subdivided into AKIN-classification stadium 1–3. AKIN: acute kidney injury network.

Table 1. Basic patient characteristics.

	AKI	Non-AKI	p Value
Parameter	n = 120	n = 118
Baseline characteristics
Age [years]	73 (64–81)	68 (56–78)	0.033
Gender (male) [% (n)]	72 (86)	67 (79)	0.483
Mortality [% (n)]	60 (73)	30 (35)	<0.001
Duration of CPR [minutes]	20 (5–40)	10 (3–20)	<0.001
Initial creatinine [mg/dl]	1.56 (1.20–2.22)	1.23 (0.90–1.92)	<0.001
Creatinine at discharge [mg/dl]	1.34 (0.76–1.77)	0.85 (0.67–1.05)	<0.001
1st shockable Rhythm [% (n)]	22 (26)	36 (43)	0.015
Duration of hospitalization [days]	17 (8–31)	19 (10–31.5)	0.340
Mechanical ventilation at IMC [days]	6 (3–13)	6 (2–11)	0.110
Comorbidities
Chronic kidney disease [% (n)]	46 (55)	42 (49)	0.516
Coronary heart disease [% (n)]	61 (73)	63 (74)	0.791
Arterial hypertension [% (n)]	79 (95)	72 (85)	0.228
Diabetes mellitus [% (n)]	39 (47)	38 (45)	0.895

Data: median (IQR); % (n). AKI: acute kidney injury; CPR: cardiopulmonary resuscitation; IMC: intermediate care.

Table 2. Causes leading to IHCA.

Causes of IHCA	All %	n = 238	AKI	n = 120	Non-AKI	n = 118	p-Value
		(n)	%	(n)	%	(n)
Referral from internal medicine	89.9	(214/238)	94.3	(113/120)	85.6	(101/118)	0.0320
Cardiac causes
Coronary angiography/PCI	15.9	(34/214)	19.5	(22/113)	11.9	(12/101)	0.1389
Cardiac arrhythmia	10.8	(23/214)	3.5	(4/113)	18.8	(19/101)	0.0001
Myocardial infarction	6.1	(13/214)	3.5	(4/113)	8.9	(9/101)	0.1506
Course after TAVI	5.6	(12/214)	6.2	(7/113)	5.0	(5/101)	0.7724
Implantation of pacemaker/ICD	2.3	(5/214)	2.7	(3/113)	2.0	(2/101)	1.0000
Transcatheter mitral valve repair	0.5	(1/214)	0.0	(0/113)	1.0	(1/101)	0.4719
Severe electrolyte imbalance	1.9	(4/214)	2.7	(3/113)	1.0	(1/101)	0.6239
Pulmonary embolism	1.9	(4/214)	3.5	(4/113)	0.0	(0/101)	0.1238
Non-cardiac causes
Event on intermediate care unit	7.5	(16/214)	9.7	(11/113)	5.0	(5/101)	0.2046
Aspiration	1.4	(3/214)	0.9	(1/113)	2.0	(2/101)	0.6032
Oncological patient	1.9	(4/214)	1.8	(2/113)	2.0	(2/101)	1.0000
Sedation and intubation	1.9	(4/214)	2.7	(3/113)	1.0	(1/101)	0.6239
Sepsis	0.9	(2/214)	1.8	(2/113)	0.0	(0/101)	0.4992
Hemodialysis	0.9	(2/214)	1.8	(2/113)	0.0	(0/101)	0.4992
Other	40.7	(87/214)	39.8	(45/113)	41.6	(42/101)	0.8892
Referral from others	8.4	(20/238)	3.3	(4/120)	13.6	(16/118)	0.0048
Course after surgery	60.0	(12/20)	75.0	(3/4)	56.3	(9/16)	0.6186
Neurologic disorder (seizure, stroke)	30.0	(6/20)	25.0	(1/4)	31.3	(5/16)	1.0000
Other	10.0	(2/20)	0.0	(0/4)	12.5	(2/16)	1.0000
Undetermined	1.7	(4/238)	2.5	(3/120)	0.9	(1/118)	0.6219

Data: % (n). PCI: percutaneous coronary intervention; TAVI: transcatheter aortic valve replacement; ICD: implantable cardioverter defibrillator.

Figure 2. Kaplan–Meier estimator. Survival within 30 days after in-hospital cardiac arrest. AKI: acute kidney injury; HD: hemodialysis.

Figure 3. Forest plot. Multivariate analysis of AKI comorbidities after IHCA. CKD: chronic kidney disease.