Abstract T MP76: Acute Kidney Injury in Acute Ischemic Strokes is Associated with Worse Outcomes
Bibliographic record
Abstract
Background: Acute Kidney Injury (AKI) in setting of acute ischemic stroke (AIS) is associated with worse outcome. Objective: To determine the effect of AKI on outcomes of AIS patients treated in a large national cohort. In a sub-analysis we looked at the outcomes of AKI in AIS patients treated with and without thrombolytic. Methods: Data from all patients admitted to US hospitals between 2002 and 2010 with a primary discharge diagnosis of ischemic stroke and secondary diagnosis of AKI treated with or without IV thrombolysis were included. The effect of AKI on rates of intracerebral hemorrhage (ICH) and discharge outcomes was analyzed after adjusting for potential confounders using logistic regression analysis. Results: Of 7,068,334 patients with AIS, 372,223 (5.3%) had AKI. AIS patients with AKI had higher rates of moderate to severe disability (41.3% versus 30% p=<0.0001), ICH (1.0% versus 0.5% p=<0.0001) and In-hospital mortality (8.4% versus 2.9% p=<0.0001) compared to those without AKI. After adjusting for potential confounders AIS patients with AKI had higher odds of moderate to severe disability [Odds ratio (OR) 1.4, 95% confidence interval (CI) (1.3-1.4, p=<0.0001)], ICH [(OR) 1.6, 95% (CI) (1.5-1.8, p=<0.0001)] and death [(OR) 2.6, 95% (CI) (2.5-2.8, p=<0.0001)]. In a sub-analysis, AIS patients with AKI who were treated with thrombolytic had higher rates of moderate to severe disability (54.5% versus 41.1% p=<0.0001), ICH (7.4% versus 0.8% p=<0.0001) and In-hospital mortality (21.4% versus 8.2% p=<0.0001) compared to those were not treated with thrombolytic. After adjusting for potential confounders AIS patients with AKI who were treated with thrombolytic had higher odds of moderate to severe disability [(OR) 1.7, 95% (CI) (1.5-2.0, p=<0.0001)], ICH [(OR) 8.0, 95% (CI) (6.1-10.2, p=<0.0001)] and death [(OR) 2.7, 95% (CI) (2.3-3.2, p=<0.0001)] compared to those were not treated with thrombolytic. Conclusion: AKI in patients with AIS is associated with significantly higher rates of disability at discharge, ICH and in-hospital mortality. In such patients, administration of thrombolytic treatment further worsens the outcome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".