Hospital related outcomes of acute kidney injury in patients with bladder cancer: A nationwide inpatient study.

person Julia Vinagolu State University of New York, Upstate Medical University, Syracuse, NY info_outline Julia Vinagolu, Saad Javaid, Kelly Frasier, Vivian Li, Nataly Ortega Yaguachi, Evadne Rodriguez, Olivia Del Castillo, Raquel Batista, Kenlee Jonas, Laura Palma

Authors person Julia Vinagolu State University of New York, Upstate Medical University, Syracuse, NY info_outline Julia Vinagolu, Saad Javaid, Kelly Frasier, Vivian Li, Nataly Ortega Yaguachi, Evadne Rodriguez, Olivia Del Castillo, Raquel Batista, Kenlee Jonas, Laura Palma Organizations State University of New York, Upstate Medical University, Syracuse, NY, Wyckoff Heights Medical Center, Brooklyn, NY, Nuvance Health/Vassar Brothers Medical Center, Poughkeepsie, NY, Lake Erie College of Osteopathic Medicine, Erie, PA, University of Missouri-Columbia, School of Medicine, Columbia, MO, Dutchess Community College, Beacon, NY Abstract Disclosures Research Funding No funding sources reported Background: Bladder cancer is the most common urinary tract cancer and is associated with a high risk of acute kidney injury(AKI). However, there is a lack of Nationwide data on bladder cancer concerning acute kidney injury. We studied the impact of AKI on bladder cancer and the predictors of these adverse outcomes. Methods: The National Inpatient Sample for the years 2017-2020 was employed to identify patients with a primary diagnosis of bladder cancer (local/regional and advanced metastatic), and they were stratified into two cohorts with and without acute kidney injury (AKI). We calculated mortality as the primary outcome and other factors such as hospital stay, cost, sepsis, and respiratory failure as secondary outcomes using multivariate regression analysis after adjusting for confounding factors. Results: A total of 102485 patients had Bladder cancer, among which 30345 had AKI. The mean age of patients with and without AKI was 74.02 vs 71.36 years, respectively (p<0.004). After adjusting for confounding variables, patients with AKI had higher odds of mortality (OR=2.7(2.06-3.54); p<0.001). Length of stay and total hospitalization cost was also significantly increased in patients with concurrent AKI (+2.5 days(2.25-2.76) and + $ 25924(21831-30017); p<0.001, respectively). Similarly, bladder cancer patients with AKI had an increased likelihood of Fluid and electrolyte disorders (OR=3.99(3.70-4.30); p<0.001), Acute respiratory failure (OR=3.65(3.09-4.32); p<0.001), Cardiac arrest (OR=4.32(2.62-7.10);p<0.001), Sepsis (OR=6.52(5.38-7.92);p <0.001), Intensive care unit admission (OR=3.19(2.73-3.73);p<0.001), Invasive mechanical ventilation (OR=3.35(2.76-4.07); p<0.001), Vasopressor use (OR=2.83(2.07-3.86);p<0.001), Pneumonia (OR=2.04(1.61-2.57); p<0.001) and constipation (OR=1.91(1.70-2.15), p<0.001). Conclusions: Our study concluded that AKI in bladder cancer patients was associated with more than twofold increased odds of mortality. The presence of AKI also leads to increased length of stay in the hospitals and increased healthcare resource utilization. Careful evaluation and prompt intervention in acute kidney injury patients can significantly improve outcomes and reduce mortality rates in individuals with bladder cancer. These proactive measures enhance patient survival and improve the quality of life with treatment. Bladder Cancer with and without AKI LOS Days (Adjusted) 2.5 (2.25-2.76) Total Charges USD (Adjusted) 25924(21831-30017) Odds Ratio(95% CI) Mortality (Adjusted) 2.7(2.06-3.54),p<0.001 Fluid and electrolyte disorders 3.99(3.70-4.30),p<0.001 Acute respiratory failure 3.65(3.09-4.32),p<0.001 Sepsis 6.52(5.38-7.92),p<0.001 Intensive care unit (ICU) 3.19(2.73-3.73),p<0.001 Mechanical ventilation 3.35(2.76-4.07),p<0.001