The economic impact of acute kidney injury in England
The economic impact of acute kidney injury in England
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DOI：
10.1093/ndt/gfu016
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发表时间：
2014-07-01
影响因子：
6.1
通讯作者：
O'Donoghue, Donal
中科院分区：
文献类型：
--
作者：
Kerr, Marion;Bedford, Michael;O'Donoghue, Donal
急性肾损伤（阿基）是影响世界各地住院患者的最常见并发症之一。它与高死亡率和不良的长期结果有关，但其患病率和费用尚不确定。我们估计阿基的患病率在医院住院患者在一个普遍的医疗保健系统，和生存的直接和长期的影响，生活质量和医疗costs.We检查阿基的患病率在住院患者使用两个常规的国家数据为英国国民健康服务（NHS），和实验室数据从东肯特医院。我们使用回归分析来估计阿基对死亡率和住院时间的影响，并使用马尔可夫模型来估计对质量调整生命年和NHS成本的影响。在医院事件统计（HES）中，阿基被记录在2.43%的住院病例中，但从实验室数据得出的年龄和性别标准化估计数表明，真实的患病率可能是其五倍以上（14.15%）。我们估计，英国每年与阿基相关的住院死亡人数可能超过40 000人。在英格兰，AKI相关住院护理的年度成本估计为10.2亿英镑，仅占NHS预算的1%以上。2010- 2011年住院期间发生阿基的患者的出院后护理终身费用估计为1.79亿澳元。住院患者的阿基患病率可能比以前认为的要高得多，并且多达五分之四的病例可能没有在常规医院数据中获得。阿基与大量住院死亡和高NHS成本相关。HES和东肯特数据的比较表明，HES中记录的大多数病例可能是相对重度的阿基（AKIN 2-3）。
Acute kidney injury (AKI) is one of the most common complications affecting hospital inpatients around the world. It is associated with high mortality and adverse long-term outcomes, but there is uncertainty regarding its prevalence and cost. We estimate the prevalence of AKI in hospital inpatients in a universal health-care system, and the immediate and long-term impacts on survival, quality of life and health-care costs.We examined prevalence of AKI in inpatients using both routine national data for the National Health Service (NHS) in England, and laboratory data from East Kent Hospitals. We used regression analyses to estimate the impact of AKI on mortality and length of hospital stay, and a Markov model to estimate the impact on quality-adjusted life years and NHS costs.AKI was recorded in 2.43% of hospital admissions in Hospital Episode Statistics (HES), but age- and gender-standardized estimates derived from laboratory data suggest the true prevalence may be more than five times as high (14.15%). We estimate that the annual number of excess inpatient deaths associated with AKI in England may be above 40 000. The annual cost of AKI-related inpatient care in England is estimated at A 1.02 pound billion, just over 1% of the NHS budget. The lifetime cost of post-discharge care for people who had AKI during hospital admission in 2010-11 is estimated at A 179 pound million.AKI prevalence in inpatients may be considerably higher than previously thought, and up to four fifths of cases may not be captured in routine hospital data. AKI is associated with large numbers of in-hospital deaths and with high NHS costs. Comparison of HES and East Kent data suggests that most of the cases recorded in HES may be relatively severe AKI (AKIN 2-3).