Outcomes, Healthcare Resource Utilization, and Costs of Overall, Community-Acquired, and Hospital-Acquired Acute Kidney Injury in COVID-19 Patients

Background: In hospitalized patients with COVID-19, acute kidney injury (AKI) is associated higher mortality, but data are lacking on healthcare resource utilization (HRU) and costs related to AKI, community-acquired AKI (CA-AKI), hospital-acquired (HA-AKI). Objectives: To quantify the burden of CA-AKI, HA-AKI among inpatients COVID-19. Methods: This retrospective cohort study included COVID-19 discharged from US hospitals in Premier PINC AI™ Healthcare Database April 1–October 31, 2020, categorized as HA-AKI, or no by ICD-10-CM diagnosis codes. Outcomes were assessed during index (initial) hospitalization 30 days postdischarge. Results: Among 208 583 inpatients, 30%, 25%, 5% had whom 10%, 7%, 23% received dialysis, respectively. Excess HRU, greater for than CA-AKI. adjusted models, vs odds ratios (ORs) (95% CI) 3.70 (3.61-3.79) 4.11 (3.92-4.31) intensive care unit use 3.52 (3.41-3.63) 2.64 (2.52-2.78) in-hospital mortality; mean length stay (LOS) differences LOS 1.8 1.24 (1.23-1.25) 5.1 1.57 (1.54-1.59); cost $7163 1.35 (1.34-1.36) $19 127 1.78 (1.75-1.81) (all P < .001). During postdischarge, readmission was ≥6% longer CA-AKI; outpatient ≥41% CA-AKI AKI. Only 30-day new dialysis (among without dialysis) similar (2.37-2.8 times AKI). Discussion: excess Other studies suggest that interventions prevent could decrease morbidity, Conclusions: models especially significantly admission, These findings support implementation patients.