NYMC Faculty Publications

Acute Kidney Injury in Subarachnoid Hemorrhage: Exploring Its Clinical Significance and Prognostic Implications

Authors

Galadu Subah, New York Medical College, Valhalla, NY, USA.
Rohan Patel, New York Medical College, Valhalla, NY, USA.
Bridget Nolan, New York Medical College, Valhalla, NY, USA.
Michael Fortunato, New York Medical College, Valhalla, NY, USA.
Aiden Lui, New York Medical College, Valhalla, NY, USA.
Anaz Uddin, New York Medical College, Valhalla, NY, USA.
Austin Li, New York Medical College, Valhalla, NY, USA.
Eris Spirollari, New York Medical College, Valhalla, NY, USA.
Halla Nuoaman, Department of Neurology, Westchester Medical Center, Valhalla, NY, USA.
Yasir Ammar Adnan, Department of Neurology, Westchester Medical Center, Valhalla, NY, USA.
Anish Thomas, Department of Neurocritical Care, Westchester Medical Center, Valhalla, NY, USA.
Stuart Brill, Department of Neurocritical Care, Westchester Medical Center, Valhalla, NY, USA.
Isaac Pak, Department of Neurocritical Care, Westchester Medical Center, Valhalla, NY, USA.
Christina Ng, Department of Neurosurgery, The University of Vermont Medical Center, Burlington, VT, USA.
Lee Hecht, Department of Neurology, Downstate Medical Center, Brooklyn, NY, USA.
Andrew Bauerschmidt, Department of Neurocritical Care, Westchester Medical Center, Valhalla, NY, USA.
Stephan Mayer, Department of Neurocritical Care, Westchester Medical Center, Valhalla, NY, USA.
Chirag D. Gandhi, Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA.
Fawaz Al-Mufti, Department of Neurology, Westchester Medical Center, Valhalla, NY, USA; Department of Neurosurgery, Westchester Medical Center, Valhalla, NY, USA. Electronic address: Fawazalmufti@outlook.com.

Author Type(s)

Student, Resident/Fellow, Faculty

DOI

10.1016/j.jstrokecerebrovasdis.2024.107843

Journal Title

Journal of Stroke and Cerebrovascular Diseases

First Page

107843

Document Type

Article

Publication Date

9-1-2024

Department

Neurology

Second Department

Neurosurgery

Third Department

Medicine

Abstract

OBJECTIVES: Subarachnoid hemorrhage (SAH) from spontaneous aneurysm rupture is a debilitating condition with high morbidity and mortality. Patients with SAH remain understudied, particularly concerning the evaluation of incidence and consequences of subsequent acute kidney injury (AKI). In this study, we aim to explore the risk factors and outcomes of AKI in SAH patients. MATERIALS AND METHODS: International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes were used to query the National Inpatient Sample (NIS) for patients with a diagnosis of SAH between 2010-2019. Subgroup analysis was stratified by AKI diagnosis during the same hospitalization. AKI and non-AKI groups were assessed for baseline clinical characteristics, interventions, complications, and outcomes. Descriptive statistics, multivariate regressions, and propensity score-matching were performed using IBM SPSS 28. RESULTS: Of 76,553 patients diagnosed with nontraumatic SAH between 2010-2019, 10,634 (13.89 %) had a comorbid diagnosis of AKI. SAH patients with AKI were older (p < 0.01) and more often obese (p < 0.01) compared to the non-AKI group. A multivariate regression found the diagnosis of AKI to be independently correlated with poor functional outcome (p < 0.001), above average length of stay (p < 0.001), and in-hospital mortality (p < 0.001) when controlling for age, SAH severity, and other comorbidities. CONCLUSIONS: This study showed significant association between AKI and adverse outcomes in SAH patients, and a correlation between AKI and heightened complication rates, poor functional outcome, extended hospital stays, and elevated mortality rates. Early detection of AKI in SAH patients is vital to improve their chances of recovery.

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