University of Oulu

Niittyvuopio, M, Vaara, S, Ohtonen, P, Pettilä, V, Liisanantti, J, Ala‐Kokko, T. Causes of death for intensive care survivors with and without acute kidney injury in 5‐year follow‐up. Acta Anaesthesiol Scand. 2021; 65: 507– 514. https://doi.org/10.1111/aas.13754

Causes of death for intensive care survivors with and without acute kidney injury in 5‐year follow‐up

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Author: Niittyvuopio, Miikka1; Vaara, Suvi2; Ohtonen, Pasi1;
Organizations: 1Division of Intensive Care Medicine, Study Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu University Hospital and Medical Research Center Oulu, Oulu, Finland
2Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2021050328485
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-12-01
Description:

Abstract

Background: Data on the causes of death and long‐term mortality of intensive care unit‐treated hospital survivors with acute kidney injury (AKI) are limited. The goal of this study was to analyze the causes of death among critically ill patients during a 5‐year follow‐up.

Methods: In this predetermined sub‐study of a prospective, observational, multi‐center cohort from the FINNAKI study, we analyzed 2436 patients who were discharged from the hospital. Statistics Finland provided the follow‐up data and causes of death.

Results: During the follow‐up, 765 (31%) patients died, of whom 295 (39%) had AKI and 73 (9.5%) had received renal replacement therapy. More than half of the deaths in both the non‐AKI and AKI groups occurred after the 1 year follow‐up (58% vs. 54%, respectively). The three most common causes of death in AKI were cardiovascular diseases (36%), malignancies (21%), and neurological diseases (11%). In early deaths (<90 days) cardiovascular causes were more prevalent in AKI patients compared to non‐AKI (38% vs 25%, P = .037.) In six cases (0.8%), the main cause of death was kidney disease, out of which five were in the AKI group. In patients with cardiovascular causes, the median time to death was shorter in AKI patients compared to non‐AKI patients (508 vs 816 days, P = .018).

Conclusions: Cardiovascular causes and malignancies account for more than half of the causes of death in patients who had suffered AKI, while death from kidney disease after AKI is rare. Early cardiovascular deaths are more prevalent in AKI compared to non‐AKI patients.

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Series: Acta anaesthesiologica Scandinavica
ISSN: 0001-5172
ISSN-E: 1399-6576
ISSN-L: 0001-5172
Volume: 65
Issue: 4
Pages: 507 - 514
DOI: 10.1111/aas.13754
OADOI: https://oadoi.org/10.1111/aas.13754
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Copyright information: © 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Niittyvuopio, M, Vaara, S, Ohtonen, P, Pettilä, V, Liisanantti, J, Ala‐Kokko, T. Causes of death for intensive care survivors with and without acute kidney injury in 5‐year follow‐up. Acta Anaesthesiol Scand. 2021; 65: 507– 514, which has been published in final form at https://doi.org/10.1111/aas.13754. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.