Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Garg, Amit X.

2nd Supervisor

Klar, Neil

Co-Supervisor

Abstract

We designed a population-based cohort study to describe the characteristics and outcomes of 6346 adults discharged home from an emergency department (ED) with acute kidney injury (AKI). Within 30 days of discharge, 149 (2.3%) patients died (stage 1: 2.1%, stage 2: 5.2%, and stage 3 AKI: 15.9%). We also compared 30-day mortality to patients hospitalized with AKI and patients discharged home with no AKI in two separate propensity score-matched analyses. An ED discharge versus hospitalization was associated with lower 30-day mortality (3.0% vs. 11.9%, relative risk (RR): 0.25, 95% confidence interval (CI): 0.21-0.30). An ED discharge home with AKI versus no AKI was associated with higher 30-day mortality (2.2% vs. 1.4%, RR: 1.56, 95% CI: 1.20-2.04). Although sicker patients are appropriately hospitalized, patients discharged home from the ED with AKI remain at risk of adverse outcomes. A better understanding of care appears warranted, as is testing strategies to improve care.

Included in

Nephrology Commons

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