Table 1 Baseline demographic and clinical characteristics based on patients’ service transition patterns: ED, emergency department; INPT, inpatient; OPT, outpatient.
Variables | Group 1 | Group 2 | Group 3 | Group 4 | p-valuea |
---|---|---|---|---|---|
OPT to OPT | OPT to ED or INPT | ED to ED or INPT | INPT to INPT | ||
Demographics, median (IQR) | 4145 (27.8%) | 1761 (11.8%) | 5545 (37.2%) | 3164 (21.2%) | |
Age, years | 58.7 (47.3, 70.5) | 64.0 (50.2, 75.6) | 56.7 (40.4, 73.2) | 64.3 (49.7, 77.5) | <0.001 |
Men, n (%) | 2481 (59.9) | 951 (54.0) | 3317 (59.8) | 1894 (59.9) | 0.418 |
Body mass index (kg/m2) | 24.7 (22.2, 27.6) | 23.8 (21.2, 26.8) | 23.5 (20.8, 26.5) | 23.5 (20.6, 26.6) | <0.001 |
Comorbidities, n (%) | |||||
Impaired kidney function | 873 (21.1) | 666 (37.8) | 1641 (29.6) | 1243 (39.3) | <0.001 |
Acute kidney failure (ICD 584.5–584.9) | 100 (2.41) | 138 (7.84) | 412 (7.43) | 246 (7.77) | <0.001 |
Diabetes mellitus | 1195 (28.8) | 599 (34.0) | 935 (16.9) | 997 (31.5) | <0.001 |
Hypertension | 1418 (34.2) | 686 (39.0) | 983 (17.7) | 1017 (32.1) | <0.001 |
Noncancerous Catastrophic illness status | 356 (8.59) | 229 (13.00) | 1058 (19.08) | 768 (24.27) | <0.001 |
Therapy, n (%) | |||||
Fluid therapy between two measurements | 29 (0.70) | 853 (48.44) | 5015 (90.44) | 2060 (65.11) | <0.001 |
Fluid therapy on the index day | 527 (12.71) | 1649 (93.64) | 5387 (97.15) | 2614 (82.62) | <0.001 |
Medication, n (%) | |||||
Angiotensin-converting-enzyme inhibitors | 439 (10.6) | 296 (16.8) | 663 (12.0) | 710 (22.4) | <0.001 |
Angiotensin II receptor blockers | 1123 (27.1) | 455 (25.8) | 513 (9.3) | 544 (17.2) | <0.001 |
Diuretics | 957 (23.1) | 751 (42.7) | 1532 (27.6) | 2118 (66.9) | <0.001 |
Oral hypoglycemic agents | 997 (24.1) | 455 (25.8) | 527 (9.5) | 596 (18.8) | <0.001 |
Insulin | 550 (13.3) | 490 (27.8) | 983 (17.7) | 1126 (35.6) | <0.001 |
NSAIDs | 1039 (25.1) | 680 (38.6) | 2514 (45.3) | 1519 (48.0) | <0.001 |
Radiocontrast | 979 (23.6) | 412 (23.4) | 1911 (34.5) | 1468 (46.4) | <0.001 |
Lab data, median (IQR) | |||||
Baseline BUN, mg/dL | 14.0 (11.0, 23.0) | 19.0 (12.0, 42.0) | 15.0 (10.5, 29.0) | 22.0 (12.7, 44.0) | <0.001 |
Second BUN, mg/dL | 14.0 (11.0, 24.0) | 21.5 (13.0, 48.0) | 14.0 (10.0, 27.0) | 23.0 (13.0, 45.0) | <0.001 |
Baseline serum creatinine, mg/dL | 0.97 (0.76, 1.32) | 1.15 (0.83, 2.19) | 1.01 (0.78, 1.65) | 1.16 (0.80, 2.01) | <0.001 |
Second serum creatinine, mg/dL | 0.96 (0.76, 1.33) | 1.15 (0.83, 2.20) | 0.99 (0.75, 1.58) | 1.20 (0.82, 2.10) | <0.001 |
Baseline eGFR, ml/min/1.73m2 | 81.7 (51.0, 99.4) | 60.1 (25.7, 90.8) | 75.9 (38.9, 100.8) | 58.3 (29.5, 92.1) | <0.001 |
Serum albumin, g/dL | 4.30 (3.80, 4.60) | 3.60 (3.00, 4.05) | 3.10 (2.50, 3.60) | 2.80 (2.30, 3.30) | <0.001 |
Hemoglobin, g/dL | 13.50 (11.70, 14.90) | 12.20 (9.90, 14.00) | 12.50 (10.75, 14.15) | 10.70 (9.35, 12.43) | <0.001 |
Sodium, mEq/L | 138.0 (137.0, 140.0) | 136.0 (133.0, 139.0) | 138.0 (135.0, 140.0) | 138.0 (134.5, 141.5) | <0.001 |
Potassium, mEq/L | 4.10 (3.80, 4.50) | 3.90 (3.60, 4.40) | 3.70 (3.40, 4.05) | 3.80 (3.35, 4.25) | <0.001 |
White blood cell count, 103/μL | 6.46 (5.24, 7.95) | 8.19 (6.13, 10.90) | 11.25 (8.27, 14.88) | 10.31 (7.43, 14.58) | <0.001 |
C-reactive protein, mg/dL | 0.17 (0.06, 0.70) | 0.97 (0.22, 4.85) | 1.60 (0.29, 7.15) | 4.51 (1.17, 12.26) | <0.001 |
Summary measures of baseline and second S-Cre | |||||
Time interval (hours) | 0.00 (0.00, 0.43) | 4.63 (2.57, 8.05) | 8.53 (6.15, 12.13) | 8.68 (5.36, 12.85) | <0.001 |
Difference (ΔS-Cre) | 0.04 (0.02, 0.07) | 0.10 (0.04, 0.15) | 0.13 (0.07, 0.26) | 0.10 (0.06, 0.21) | <0.001 |
Percent change (ΔS-Cre%) | 3.66 (1.79, 6.82) | 6.00 (2.74, 11.11) | 12.24 (6.20, 21.01) | 9.09 (4.26, 17.12) | <0.001 |
Outcome | |||||
Deaths before 2017–12–31 | 736 (17.8) | 677 (38.4) | 2353 (42.4) | 1928 (60.9) | <0.001 |
3-year all-cause deaths | 423 (10.2) | 410 (23.3) | 1719 (31.0) | 1563 (49.4) | <0.001 |
1-year all-cause deaths | 187 (4.5) | 244 (13.9) | 1219 (22.0) | 1211 (38.3) | <0.001 |
30-day all-cause deaths | 14 (0.3) | 41 (2.3) | 604 (10.9) | 634 (20.0) | <0.001 |