Table 3.
Mortality Rates and Rate Ratios
| Subgroup | Number of Studies | Deaths/Person-years (Deaths per 100 person-years) | # of Studies Demonstrating Harm | Rate Ratio | Heterogeneity (I2) | ||
|---|---|---|---|---|---|---|---|
| Point Estimate > 1 | Lower Bound 95% CI > 1 | ||||||
| AKI | No-AKI | ||||||
| Overall | 15 | 685/7665 (8.9) | 3739/87014 (4.3) | 15 | 12 | 2.59 (1.97-3.42) | 86% |
| Definition of AKI | |||||||
| At least Mild | 3 | 250/3972 (6.3) | 340/9908 (3.4) | 3 | 3 | 1.67 (1.41-1.98) | 0% |
| At least Moderate | 6 | 325/2928 (11.1) | 2980/67488 (4.4) | 6 | 4 | 2.73 (1.81-4.14) | 90% |
| Severe (RRT) | 7 | 148/1079 (13.7) | 590/13351 (4.4) | 7 | 6 | 3.04 (2.13-4.33) | 60% |
| Clinical Setting | |||||||
| Critical Illness | 2 | 48/347 (13.8) | 173/3743 (4.6) | 2 | 1 | 2.41 (1.50-3.85) | 0% |
| Cardiac Surgery | 3 | 97/1335 (7.3) | 327/11956 (2.7) | 3 | 3 | 3.72 (1.49-6.94) | 85% |
| PCI | 4 | 218/1670 (13.1) | 2793/66350 (4.2) | 4 | 4 | 2.89 (2.32-3.61) | 49% |
| Non-renal transplant | 3 | 92/1632 (5.6) | 204/2884 (7.1) | 3 | 1 | 1.89 (0.9-3.96) | 82% |
| LVAD | 2 | 59/581 (10.2) | 79/1582 (5.0) | 2 | 2 | 2.15 (1.53-3.03) | 0% |
| Aortic Surgery | 1 | 171/3840 (4.5) | 163/5290 (3.1) | 1 | 1 | 1.45 (1.17-1.79) | N/A |
| Duration | |||||||
| Transient vs. none | 2 | 201/2298 (8.7) | 301/9645(3.1) | 2 | 2 | 2.54 (2.10-3.06) | 0% |
| Persistent vs. none | 2 | 124/1370 (9.1) | 301/9645 (3.1) | 2 | 2 | 2.46 (1.68-3.60) | 49% |
| Persistent vs. transient | 3 | 186/2150 (8.7) | 232/2923 (7.9) | 2 | 1 | 1.15 (0.84-1.57) | 45% |
Mild AKI: Rise in creatinine by > 25% or drop in creatinine clearance of > 10%
Moderate AKI: Rise in creatinine by > 50%, > 100%, > 1.0 mg/dl, or creatinine concentration > 1.7 mg/dL
Severe AKI: Need for RRT
Transient AKI: Welton et al defined as recovery within 10% of baseline value at day 3; Liano and Loef et al defined serum creatinine value at the time of discharge returned to preoperative level or below.
Persistent AKI:
Abbreviations: AKI, acute kidney injury; PCI- percutaneous coronary interventions; LVAD- left ventricular assist device; RRT- AKI requiring dialysis