S HERATH1, S KOTWAL2, Z ENDRE1,3
1University of New South Wales, Sydney, New South Wales; 2The George Institute for Global Health, Sydney, New South Wales; 3Prince of Wales Hospital, Sydney, New South Wales
Aim: To quantify delays in care and identify costs in hospitalized patients with AKI.
Background: Acute kidney injury (AKI) is associated with adverse outcome and increased health care burden, but few studies in Australia have systematically assessed delays in care and costs in hospitalised patients.
Methods: Prospective data was collected on 100 consecutive adult patients with AKI referred to nephrology at an urban tertiary care centre. AKI was defined using KDIGO criteria. Baseline characteristics, treating team, time to nephrology consult and the respective costs for management of AKI were recorded. Length of stay was defined as time from AKI diagnosis to discharge from renal services.
Results: Of 100 patients consulted over the course of 8 months, 64 were male, median age 74 years. 52 patients had Stage 3 CKD or higher; 36 had diabetes, and 45 had systolic heart failure. 16 patients had stage two and 44 stage three AKI.
The median time between AKI development to nephrology consult for 83 patients was 1 (interquartile range 3). For 17/100 patients, the renal team became the caring team during the admission.
The median length of stay and costs for patients admitted under the nephrology team was 9 (13.5) days and 190 (41) dollars respectively while it was 14 (20) days and 212 (149) dollars for patients admitted under non-nephrology teams. There wasn’t a correlation between time to consult and length of stay or costs for patients admitted under non-nephrology teams.
Conclusion: There was a tendency for increased costs and length of stay for patients admitted under non-nephrology teams but this did not reach statistical significance due to the smaller sample nature of our pilot study.