Table 2.
Adjusted Odds Ratiosa (OR) of AKI in Hospitalized Adults with Diabetes Mellitus, 2000–2010.
| Model 1 | Model 2 | Model 3 | |||||||
|---|---|---|---|---|---|---|---|---|---|
|
| |||||||||
| Variable | B | SE | eB [OR (95% CI)] | B | SE | eB [OR (95% CI)] | B | SE | eB [OR (95% CI)] |
| Race (B vs. W) | 0.41 | 0.05 | 1.51*** (1.37–1.67) | 0.39 | 0.05 | 1.48*** (1.35–1.63) | 0.54 | 0.14 | 1.71 (1.31–2.25)*** |
|
| |||||||||
| Age (years) | |||||||||
| 18–24 | – | – | 1.00 (ref) | – | – | 1.00 (ref) | – | – | 1.00 (ref) |
| 25–34 | 0.06 | 0.23 | 1.06 (0.67–1.68) | 0.07 | 0.24 | 1.07 (0.66–1.73) | 0.10 | 0.26 | 1.11 (0.67–1.83) |
| 35–44 | 0.06 | 0.19 | 1.06 (0.72–1.54) | 0.13 | 0.20 | 1.14 (0.77–1.68) | 0.19 | 0.21 | 1.22 (0.80–1.85) |
| 45–54 | 0.03 | 0.20 | 1.03 (0.69–1.52) | 0.17 | 0.21 | 1.18 (0.78–1.78) | 0.23 | 0.22 | 1.26 (0.81–1.95) |
| 55–64 | 0.32 | 0.20 | 1.37 (0.93–2.03) | 0.43 | 0.21 | 1.53 (1.02–2.30) | 0.51 | 0.22 | 1.67 (1.08–2.59)* |
| 65–74 | 0.27 | 0.18 | 1.30 (0.91–1.87) | 0.33 | 0.19 | 1.39 (0.95–2.01) | 0.46 | 0.21 | 1.59 (1.05–2.40)* |
| ≥ 75 | 0.46 | 0.19 | 1.58 (1.09–2.29)* | 0.42 | 0.20 | 1.52 (1.0.3–2.23)* | 0.54 | 0.22 | 1.72 (1.11–2.64)* |
|
| |||||||||
| Sex (F vs. M) | 0.23 | 0.04 | 1.26 (1.17–1.36)*** | 0.16 | 0.04 | 1.18 (1.09–1.27)*** | 0.15 | 0.04 | 1.17 (1.08–1.26)*** |
|
| |||||||||
| AKI-Risk | |||||||||
| Factors: | |||||||||
| CKD | – | – | – | 1.26 | 0.06 | 3.53 (3.16–3.94)*** | 1.21 | 0.06 | 3.34 (3.00–3.73)*** |
| Sepsis | – | – | – | 0.98 | 0.07 | 2.66 (2.31–3.06)*** | 0.96 | 0.07 | 2.60 (2.25–3.01)*** |
| Hypertension | – | – | – | −1.01 | 0.05 | 0.36 (0.33–0.40)*** | −1.02 | 0.05 | 0.36 (0.32–0.40)*** |
| Hypotension | – | – | – | 0.75 | 0.09 | 2.13 (1.78–2.55)*** | 0.73 | 0.10 | 2.08 (1.72–2.51)*** |
| LOS (days) | – | – | – | 0.03 | 0.00 | 1.03 (1.02–1.04)*** | 0.03 | 0.00 | 1.03 (1.02–1.03)*** |
| AMI | – | – | – | 0.25 | 0.08 | 1.29 (1.10–1.50)* | 0.19 | 0.08 | 1.21 (1.03–1.43)* |
| CHF | – | – | – | 0.21 | 0.04 | 1.23 (1.14–1.33)*** | 0.21 | 0.04 | 1.23 (1.13–1.33)*** |
| Angiography | – | – | – | −0.65 | 0.10 | 0.52 (0.43–0.63)*** | −0.70 | 0.10 | 0.50 (0.41–0.60)*** |
| CLD | – | – | – | −0.09 | 0.15 | 0.92 (0.69–1.22) | −0.11 | 0.15 | 0.90 (0.67–1.21) |
| CT scan | – | – | – | −0.25 | 0.12 | 0.78 (0.62–0.98)* | −0.37 | 0.13 | 0.69 (0.54–0.89)** |
|
| |||||||||
| Admission Source: | |||||||||
| ER (ref) | – | – | – | – | – | – | – | – | 1.00 (ref) |
| Clinic | – | – | – | – | – | – | −0.32 | 0.06 | 0.73(0.65–0.82)*** |
| Transfer | – | – | – | – | – | – | 0.44 | 0.07 | 1.56 (1.36–1.78)*** |
| Other | – | – | – | – | – | – | −0.09 | 0.18 | 0.92 (0.65–1.30) |
|
| |||||||||
| Payor Source: | |||||||||
| Medicare | – | – | – | – | – | – | – | – | 1.00 (ref) |
| Medicaid | – | – | – | – | – | – | 0.14 | 0.09 | 1.16 (0.97–1.38) |
| Private | – | – | – | – | – | – | −0.06 | 0.07 | 0.94 (0.83–1.08) |
| Other | – | – | – | – | – | – | 0.08 | 0.10 | 1.08 (0.90–1.30) |
|
| |||||||||
| Race/Payor Interaction† | |||||||||
| Medicare | – | – | – | – | – | – | −0.29 | 0.15 | 0.75 (0.56–1.00) |
| Medicaid | – | – | – | – | – | – | −0.23 | 0.20 | 0.79 (0.54–1.17) |
| Private | – | – | – | – | – | – | −0.04 | 0.16 | 0.96 (0.70–1.31) |
| Other‡ | – | – | – | ||||||
|
| |||||||||
| Region: | |||||||||
| Northeast | – | – | – | – | – | – | – | – | 1.00 (ref) |
| Midwest | – | – | – | – | – | – | −0.04 | 0.07 | 0.96 (0.84–1.11) |
| South | – | – | – | – | – | – | 0.13 | 0.06 | 1.14 (1.00–1.29) |
| West | – | – | – | – | – | – | 0.09 | 0.08 | 1.09 (0.93–1.28) |
|
| |||||||||
| Hospital size | |||||||||
| (≥ 300 vs. <300 beds) | – | – | – | – | – | – | 0.29 | 0.05 | 1.34 (1.21–1.49)*** |
|
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| Constant | −3.39 | 0.19 | – | −3.43 | 0.20 | – | −3.58 | 0.22 | – |
eB= exponentiated beta (odds ratio).
Analysis based on 276,138 discharge records, among which 4,368 blacks and 9,380 whites had AKI. Odds ratios are inflated to national estimates (population size 408,647,876) based on survey design variables provided by the National Hospital Discharge Survey.
B= Blacks, W= Whites (ref); F = Female; M= Male (ref); Ref= reference group for comparisons of categorical variables. LOS= length of stay. AMI= acute myocardial infarction. CLD= chronic liver disease. CT= computed tomography. ER= emergency room.
Bolded values indicate significant associations.
P<0.05;
P <0.01;
P <0.001.
Blacks with vs. without specified insurance.
Omitted from model because of collinearity.