Risk factors for acute kidney injury in the elderly undergoing contrast-enhanced computed tomography in the emergency department

Ming Kun Huang, Teh Fu Hsu, Yu Hui Chiu, Shu Chiung Chiang, Wei Fong Kao, David Hung Tsang Yen, Mu Shun Huang

Research output: Contribution to journalArticle

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Abstract

Background: There have been few studies focusing on the incidence and risk factors for elderly patients undergoing computed tomography (CT) scans with intravascular contrast medium, who develop contrast-induced nephropathy (CIN) in the emergency department (ED). Our objective was to investigate the incidence of and risk factors for, CIN in elderly patients seen in the ED, who receive intravenous contrast media for CT examination. Methods: Patients ≥65 years of age who received contrast-enhanced CT were eligible for inclusion in this retrospective analysis. CIN was defined as an increase in serum creatinine (sCr) ≥0.5 mg/dL 48 to 72 hours after intravenous contrast administration. Multiple logistic regression analysis for risk factors for CIN and Chi-square test were performed for trend analysis for CIN incidence and mortality of different risk scores. Results: A total of 594 patients, with a mean age of 79.8 ± 6.8 years were included. The overall incidence of CIN was 8.6%. In multivariate analyses, CIN was associated with diabetes mellitus [adjusted odds ratio (OR) = 1.93; 95% confidence interval (CI) = 1.04-3.62], precontrast sCr >1.5 mg/dL (OR = 2.72; 95% CI = 1.44-5.13), and acute hypotension (OR = 3.56; 95% CI = 1.29-9.84). CIN and mortality increased with increasing risk score (p <0.001 and p = 0.001, respectively). The all-cause in-hospital mortality rate was 13.1%, and the mortality rates for patients with and without CIN (p <0.001) were 47.1% and 9.9%, respectively. Conclusion: Our investigation confirmed diabetes mellitus, precontrast sCr >1.5 mg/dL and acute hypotension as risk factors for CIN, and also developed a simple risk score for elderly patients seen in the ED.

Original languageEnglish
Pages (from-to)271-276
Number of pages6
JournalJournal of the Chinese Medical Association
Volume76
Issue number5
DOIs
Publication statusPublished - May 2013
Externally publishedYes

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Acute Kidney Injury
Hospital Emergency Service
Tomography
Odds Ratio
Incidence
Confidence Intervals
Hypotension
Contrast Media
Creatinine
Mortality
Chi-Square Distribution
Serum
Intravenous Administration
Diabetes Mellitus
Multivariate Analysis
Logistic Models
Regression Analysis

Keywords

  • Acute kidney injury
  • Aged
  • Contrast media
  • Emergency department
  • Risk factors

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Risk factors for acute kidney injury in the elderly undergoing contrast-enhanced computed tomography in the emergency department. / Huang, Ming Kun; Hsu, Teh Fu; Chiu, Yu Hui; Chiang, Shu Chiung; Kao, Wei Fong; Yen, David Hung Tsang; Huang, Mu Shun.

In: Journal of the Chinese Medical Association, Vol. 76, No. 5, 05.2013, p. 271-276.

Research output: Contribution to journalArticle

Huang, Ming Kun ; Hsu, Teh Fu ; Chiu, Yu Hui ; Chiang, Shu Chiung ; Kao, Wei Fong ; Yen, David Hung Tsang ; Huang, Mu Shun. / Risk factors for acute kidney injury in the elderly undergoing contrast-enhanced computed tomography in the emergency department. In: Journal of the Chinese Medical Association. 2013 ; Vol. 76, No. 5. pp. 271-276.
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abstract = "Background: There have been few studies focusing on the incidence and risk factors for elderly patients undergoing computed tomography (CT) scans with intravascular contrast medium, who develop contrast-induced nephropathy (CIN) in the emergency department (ED). Our objective was to investigate the incidence of and risk factors for, CIN in elderly patients seen in the ED, who receive intravenous contrast media for CT examination. Methods: Patients ≥65 years of age who received contrast-enhanced CT were eligible for inclusion in this retrospective analysis. CIN was defined as an increase in serum creatinine (sCr) ≥0.5 mg/dL 48 to 72 hours after intravenous contrast administration. Multiple logistic regression analysis for risk factors for CIN and Chi-square test were performed for trend analysis for CIN incidence and mortality of different risk scores. Results: A total of 594 patients, with a mean age of 79.8 ± 6.8 years were included. The overall incidence of CIN was 8.6{\%}. In multivariate analyses, CIN was associated with diabetes mellitus [adjusted odds ratio (OR) = 1.93; 95{\%} confidence interval (CI) = 1.04-3.62], precontrast sCr >1.5 mg/dL (OR = 2.72; 95{\%} CI = 1.44-5.13), and acute hypotension (OR = 3.56; 95{\%} CI = 1.29-9.84). CIN and mortality increased with increasing risk score (p <0.001 and p = 0.001, respectively). The all-cause in-hospital mortality rate was 13.1{\%}, and the mortality rates for patients with and without CIN (p <0.001) were 47.1{\%} and 9.9{\%}, respectively. Conclusion: Our investigation confirmed diabetes mellitus, precontrast sCr >1.5 mg/dL and acute hypotension as risk factors for CIN, and also developed a simple risk score for elderly patients seen in the ED.",
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T1 - Risk factors for acute kidney injury in the elderly undergoing contrast-enhanced computed tomography in the emergency department

AU - Huang, Ming Kun

AU - Hsu, Teh Fu

AU - Chiu, Yu Hui

AU - Chiang, Shu Chiung

AU - Kao, Wei Fong

AU - Yen, David Hung Tsang

AU - Huang, Mu Shun

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N2 - Background: There have been few studies focusing on the incidence and risk factors for elderly patients undergoing computed tomography (CT) scans with intravascular contrast medium, who develop contrast-induced nephropathy (CIN) in the emergency department (ED). Our objective was to investigate the incidence of and risk factors for, CIN in elderly patients seen in the ED, who receive intravenous contrast media for CT examination. Methods: Patients ≥65 years of age who received contrast-enhanced CT were eligible for inclusion in this retrospective analysis. CIN was defined as an increase in serum creatinine (sCr) ≥0.5 mg/dL 48 to 72 hours after intravenous contrast administration. Multiple logistic regression analysis for risk factors for CIN and Chi-square test were performed for trend analysis for CIN incidence and mortality of different risk scores. Results: A total of 594 patients, with a mean age of 79.8 ± 6.8 years were included. The overall incidence of CIN was 8.6%. In multivariate analyses, CIN was associated with diabetes mellitus [adjusted odds ratio (OR) = 1.93; 95% confidence interval (CI) = 1.04-3.62], precontrast sCr >1.5 mg/dL (OR = 2.72; 95% CI = 1.44-5.13), and acute hypotension (OR = 3.56; 95% CI = 1.29-9.84). CIN and mortality increased with increasing risk score (p <0.001 and p = 0.001, respectively). The all-cause in-hospital mortality rate was 13.1%, and the mortality rates for patients with and without CIN (p <0.001) were 47.1% and 9.9%, respectively. Conclusion: Our investigation confirmed diabetes mellitus, precontrast sCr >1.5 mg/dL and acute hypotension as risk factors for CIN, and also developed a simple risk score for elderly patients seen in the ED.

AB - Background: There have been few studies focusing on the incidence and risk factors for elderly patients undergoing computed tomography (CT) scans with intravascular contrast medium, who develop contrast-induced nephropathy (CIN) in the emergency department (ED). Our objective was to investigate the incidence of and risk factors for, CIN in elderly patients seen in the ED, who receive intravenous contrast media for CT examination. Methods: Patients ≥65 years of age who received contrast-enhanced CT were eligible for inclusion in this retrospective analysis. CIN was defined as an increase in serum creatinine (sCr) ≥0.5 mg/dL 48 to 72 hours after intravenous contrast administration. Multiple logistic regression analysis for risk factors for CIN and Chi-square test were performed for trend analysis for CIN incidence and mortality of different risk scores. Results: A total of 594 patients, with a mean age of 79.8 ± 6.8 years were included. The overall incidence of CIN was 8.6%. In multivariate analyses, CIN was associated with diabetes mellitus [adjusted odds ratio (OR) = 1.93; 95% confidence interval (CI) = 1.04-3.62], precontrast sCr >1.5 mg/dL (OR = 2.72; 95% CI = 1.44-5.13), and acute hypotension (OR = 3.56; 95% CI = 1.29-9.84). CIN and mortality increased with increasing risk score (p <0.001 and p = 0.001, respectively). The all-cause in-hospital mortality rate was 13.1%, and the mortality rates for patients with and without CIN (p <0.001) were 47.1% and 9.9%, respectively. Conclusion: Our investigation confirmed diabetes mellitus, precontrast sCr >1.5 mg/dL and acute hypotension as risk factors for CIN, and also developed a simple risk score for elderly patients seen in the ED.

KW - Acute kidney injury

KW - Aged

KW - Contrast media

KW - Emergency department

KW - Risk factors

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