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Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China

OBJECTIVE: To investigate the relationship between health insurance status and outcomes of septic acute kidney injury (AKI) related hospitalizations in an intensive care unit (ICU) in Ningbo, China. METHODS: For this retrospective study, information was extracted from patients notes and billing reco...

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Autores principales: Fan, Heng, Zhao, Yu, Chen, Guo-dong, Sun, Min, Zhu, Jian-Hua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384465/
https://www.ncbi.nlm.nih.gov/pubmed/30328368
http://dx.doi.org/10.1177/0300060518802526
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author Fan, Heng
Zhao, Yu
Chen, Guo-dong
Sun, Min
Zhu, Jian-Hua
author_facet Fan, Heng
Zhao, Yu
Chen, Guo-dong
Sun, Min
Zhu, Jian-Hua
author_sort Fan, Heng
collection PubMed
description OBJECTIVE: To investigate the relationship between health insurance status and outcomes of septic acute kidney injury (AKI) related hospitalizations in an intensive care unit (ICU) in Ningbo, China. METHODS: For this retrospective study, information was extracted from patients notes and billing records for patients >18 years of age with a diagnosis of AKI admitted to the ICU department, Ningbo First Hospital from April 2013 to March 2018. RESULTS: Of the 368 patients with sepsis admitted to ICU, 167 (45%) developed AKI; 95 patients were insured and 72 were uninsured. Compared with insured patients, uninsured patients were younger, had higher Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, but had less catheter interventions and received less renal replacement therapy (RRT). Results from a multivariate analysis showed that independent predictors of ICU mortality were age, APACHE II scores, MODS scores, use of RRT and lack of insurance. CONCLUSIONS: Uninsured patients with septic AKI were younger, stayed a shorter time in ICU, had higher illness severity scores and a higher ICU mortality than insured patients. Importantly a major risk factor for ICU mortality in this group was lack of insurance.
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spelling pubmed-63844652019-02-27 Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China Fan, Heng Zhao, Yu Chen, Guo-dong Sun, Min Zhu, Jian-Hua J Int Med Res Clinical Research Reports OBJECTIVE: To investigate the relationship between health insurance status and outcomes of septic acute kidney injury (AKI) related hospitalizations in an intensive care unit (ICU) in Ningbo, China. METHODS: For this retrospective study, information was extracted from patients notes and billing records for patients >18 years of age with a diagnosis of AKI admitted to the ICU department, Ningbo First Hospital from April 2013 to March 2018. RESULTS: Of the 368 patients with sepsis admitted to ICU, 167 (45%) developed AKI; 95 patients were insured and 72 were uninsured. Compared with insured patients, uninsured patients were younger, had higher Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, but had less catheter interventions and received less renal replacement therapy (RRT). Results from a multivariate analysis showed that independent predictors of ICU mortality were age, APACHE II scores, MODS scores, use of RRT and lack of insurance. CONCLUSIONS: Uninsured patients with septic AKI were younger, stayed a shorter time in ICU, had higher illness severity scores and a higher ICU mortality than insured patients. Importantly a major risk factor for ICU mortality in this group was lack of insurance. SAGE Publications 2018-10-17 2019-01 /pmc/articles/PMC6384465/ /pubmed/30328368 http://dx.doi.org/10.1177/0300060518802526 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Clinical Research Reports
Fan, Heng
Zhao, Yu
Chen, Guo-dong
Sun, Min
Zhu, Jian-Hua
Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China
title Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China
title_full Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China
title_fullStr Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China
title_full_unstemmed Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China
title_short Health insurance status and risk factors of mortality in patients with septic acute kidney injury in Ningbo, China
title_sort health insurance status and risk factors of mortality in patients with septic acute kidney injury in ningbo, china
topic Clinical Research Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6384465/
https://www.ncbi.nlm.nih.gov/pubmed/30328368
http://dx.doi.org/10.1177/0300060518802526
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