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International Journal of Latest Research in Science and Technology

DOI:10.29111/ijlrst   ISRA Impact Factor:3.35

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RENAL DYSFUNCTION IS NOT ONLY A RISK FACTOR BUT ALSO A SURROGATE MARKER FOR LONGER HOSPITAL STAY IN AN ACUTE GENERAL MEDICAL UNIT

Research Paper Open Access

International Journal of Latest Research in Science and Technology Vol.4 Issue 1, pp 1-3,Year 2015

RENAL DYSFUNCTION IS NOT ONLY A RISK FACTOR BUT ALSO A SURROGATE MARKER FOR LONGER HOSPITAL STAY IN AN ACUTE GENERAL MEDICAL UNIT

S S Wei, J A Marsh,B Mulo

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Received : 15 January 2015; Accepted : 03 February 2015 ; Published : 28 February 2015

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Abstract

Objective: To assess the relationship between renal function and the length of hospital stay in patients admitted to Acute Medical Unit (AMU). Methods: We evaluated all patients admitted to the AMU of a tertiary hospital between August to September 2011. Patients were categorised into two groups according to their renal function on admission. Group ‘A’ patients had an estimated glomerular filtration rate (eGFR) greater than 60ml/min and Group ‘B’ had an eGFR of less than 60ml/min. We analysed and compared the mean length of stay (LOS) and the clinical outcome between these two groups of patients. Results: 608 patients with mean age of 75.4 +/- 16.7 were admitted during the study. Out of the 608 patients, 338 were female and 270 were male. 337 patients (55%) were classified as Group A and the remaining 47% were in group B according to their admission renal function. Group A patients were significantly younger (70.3 ± 18.6) than group B (81.7 ± 10.9) with P<0.01. 71.5% of patients in group B had stage 3 chronic kidney disease. Independent of the underlying medical conditions, group B patients had a 20% increase in hospital stay compared to group A (hazard ratio = 1.20, 95% CI = 1.01-1.43, p <0.04). Among group B patients, a 50% increases in hospital stay was observed for those who made a significant recovery in their renal function (hazard ratio 1.50, 95% CI = 1.15-1.99, p < 0.003). Patients with worsening renal dysfunction after admission did not predict longer hospital stay (hazard ratio 1.23, 95% CI = 0.84-1.87, p= NS). The presence of bacteriuria was not associated with increased LOS (95% CI: -2, 42; p=0.09). No association was detected between LOS and either age or gender. Conclusion: Nearly half of the patients presented to the acute medical unit had various degree of renal dysfunction. Elderly patients with renal dysfunction had a 20% increase in hospital stay. The presence of bacteriuria was not associated with a longer hospital stay. Non-dialysis renal dysfunction patients who made a significant renal recovery during their hospital stay had a 50% longer hospital stay. The finding suggests renal dysfunction is not only an independent risk factor but also a surrogate marker reflecting the severity of the underlying medical condition in predicting patient length of hospital stay especially in elderly patients with significant recovering renal function.

Key Words   
general medicine, kidney function, eGFR, length of stay, chronic kidney disease

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References
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To cite this article

S S Wei, J A Marsh,B Mulo , " Renal Dysfunction Is Not Only A Risk Factor But Also A Surrogate Marker For Longer Hospital Stay In An Acute General Medical Unit ", International Journal of Latest Research in Science and Technology . Vol. 4, Issue 1, pp 1-3 , 2015

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