Impact of Acute Kidney Injury on Mortality Outcomes in Patients Hospitalized for COPD Exacerbation: A National Inpatient Sample Analysis
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Demographical Data
3.1.1. Baseline Demographics
3.1.2. Mortality and Inpatient Complication Demographics
3.1.3. Comorbidity Distribution
3.2. Multivariate Analysis Data
3.2.1. Demographic Risk Factors and Mortality
3.2.2. Hospital Complications and Mortality
3.2.3. Comorbidities and Mortality
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
AKI | Acute Kidney Injury |
COPD | Chronic Obstructive Pulmonary Disease |
COPDe | COPD Exacerbation |
NIS | National Inpatient Sample |
HCUP | Healthcare Cost and Utilization Project |
LOS | Length of Stay |
HTN | Hypertension |
DLD | Dyslipidemia |
DM | Diabetes Mellitus |
CKD3–4 | Chronic Kidney Disease Stage 3 to 4 |
CAD | Coronary Artery Disease |
OSA | Obstructive Sleep Apnea |
CVD | Cerebrovascular Disease |
GERD | Gastroesophageal Reflux Disease |
Pulm HTN | Pulmonary Hypertension |
OR | Odds Ratio |
CI | Confidence Interval |
ESKD | End-Stage Kidney Disease |
RRT | Renal Replacement Therapy |
UTI | Urinary Tract Infection |
KDIGO | Kidney Disease Improving Global Outcomes |
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Variable * | With AKI (n = 55,270) | Without AKI (n = 350,575) | p-Value |
---|---|---|---|
Age, mean (SD) | 72.69 (±10.29) | 69.55 (±10.84) | 0.01 ** |
LOS, mean (SD) | 6.12 (±5.40) | 4.58 (±3.98) | 0.015 *** |
Female, n (%) | 24,306 (44.0%) | 190,102 (54.2%) | <0.001 **** |
Race, n (%) | <0.001 **** | ||
White | 41,523 (76.9%) | 275,654 (80.5%) | |
Black | 7515 (13.9%) | 38,915 (11.4%) | |
Hispanic | 2880 (5.3%) | 16,399 (4.8%) | |
Asian | 897 (1.7%) | 4082 (1.2%) | |
Native American | 232 (0.4%) | 1554 (0.5%) | |
Other | 981 (1.8%) | 5894 (1.7%) | |
Comorbidities, n (%) | |||
HTN | 46,596 (84.3%) | 253,850 (72.4%) | <0.001 **** |
DLD | 20,164 (36.5%) | 103,124 (29.4%) | <0.001 **** |
DM | 22,274 (40.3%) | 100,466 (28.7%) | <0.001 **** |
CKD3–4 | 17,129 (31.0%) | 24,920 (7.1%) | <0.001 **** |
CAD | 19,329 (35.0%) | 97,045 (27.7%) | <0.001 **** |
OSA | 9191 (16.6%) | 48,413 (13.8%) | <0.001 **** |
CVD | 412 (0.7%) | 1314 (0.4%) | <0.001 **** |
GERD | 14,965 (27.1%) | 100,214 (28.6%) | <0.001 **** |
Pulm HTN | 6143 (11.1%) | 28,861 (8.2%) | <0.001 **** |
Hospital outcomes, n (%) | |||
Pneumonia | 23,326 (42.2%) | 124,112 (35.4%) | <0.001 **** |
Acute respiratory failure | 32,268 (58.4%) | 181,124 (51.7%) | <0.001 **** |
Intubation | 5918 (10.7%) | 13,837 (3.9%) | <0.001 **** |
Vasopressor support | 651 (1.2%) | 744 (0.2%) | <0.001 **** |
Inpatient mortality | 3213 (5.8%) | 5728 (1.6%) | <0.001 **** |
Variable * | OR | 95% CI (Lower) | 95% CI (Upper) | p-Value |
---|---|---|---|---|
AKI | 2.417 | 2.295 | 2.545 | <0.001 |
Age | 1.049 | 1.046 | 1.051 | <0.001 |
Female | 0.872 | 0.833 | 0.913 | <0.001 |
Race (White = reference) | ||||
Black | 0.718 | 0.66 | 0.781 | <0.001 |
Hispanic | 0.783 | 0.697 | 0.879 | <0.001 |
Asian | 0.99 | 0.83 | 1.181 | 0.913 |
Native American | 1.074 | 0.752 | 1.535 | 0.693 |
Other | 0.876 | 0.735 | 1.044 | 0.138 |
Comorbidities | ||||
HTN | 0.747 | 0.709 | 0.787 | <0.001 |
DLD | 0.959 | 0.911 | 1.01 | 0.112 |
DM | 0.8 | 0.758 | 0.844 | <0.001 |
CKD3–4 | 0.816 | 0.758 | 0.879 | <0.001 |
CAD | 0.94 | 0.893 | 0.991 | 0.021 |
OSA | 0.66 | 0.61 | 0.714 | <0.001 |
CVD | 2.739 | 2.259 | 3.321 | <0.001 |
GERD | 0.821 | 0.778 | 0.867 | <0.001 |
Pulm HTN | 1.167 | 1.088 | 1.252 | <0.001 |
Hospital outcomes | ||||
Pneumonia | 1.293 | 1.236 | 1.354 | <0.001 |
Acute respiratory failure | 4.559 | 4.245 | 4.897 | <0.001 |
Intubation | 10.262 | 9.744 | 10.808 | <0.001 |
Vasopressor | 2.736 | 2.385 | 3.138 | <0.001 |
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Morcos, Z.; Daniel, R.; Hassan, M.; Qandil, H.; Lahoud, C.; Wei, C.; El Sayegh, S. Impact of Acute Kidney Injury on Mortality Outcomes in Patients Hospitalized for COPD Exacerbation: A National Inpatient Sample Analysis. J. Clin. Med. 2025, 14, 5393. https://doi.org/10.3390/jcm14155393
Morcos Z, Daniel R, Hassan M, Qandil H, Lahoud C, Wei C, El Sayegh S. Impact of Acute Kidney Injury on Mortality Outcomes in Patients Hospitalized for COPD Exacerbation: A National Inpatient Sample Analysis. Journal of Clinical Medicine. 2025; 14(15):5393. https://doi.org/10.3390/jcm14155393
Chicago/Turabian StyleMorcos, Zeina, Rachel Daniel, Mazen Hassan, Hamza Qandil, Chloe Lahoud, Chapman Wei, and Suzanne El Sayegh. 2025. "Impact of Acute Kidney Injury on Mortality Outcomes in Patients Hospitalized for COPD Exacerbation: A National Inpatient Sample Analysis" Journal of Clinical Medicine 14, no. 15: 5393. https://doi.org/10.3390/jcm14155393
APA StyleMorcos, Z., Daniel, R., Hassan, M., Qandil, H., Lahoud, C., Wei, C., & El Sayegh, S. (2025). Impact of Acute Kidney Injury on Mortality Outcomes in Patients Hospitalized for COPD Exacerbation: A National Inpatient Sample Analysis. Journal of Clinical Medicine, 14(15), 5393. https://doi.org/10.3390/jcm14155393