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논문분류	춘계학술대회 초록집
제목	Frailty as a predictor of acute kidney injury in hospitalized elderly patients: a single center, retrospective cohort study
저자	Seon Ha Baek* 1, Sung Woo Lee2, Sun-Wook Kim1, Shin Young Ahn3, Mi-Yeon Yu4, Kwang-Il Kim1, Ho Jun Chin1, Ki Young Na1, Dong-Wan Chae1, Sejoong Kim1
출판정보	2016; 2016(1):
키워드	Acute kidney injury, elderly patient, Frailty
초록	Background: Elderly patients have an increased risk for acute kidney injury (AKI). However, no study has thus far reported a predictor for AKI in geriatric patients. Therefore, we aimed at determining the effect of frailty as a predictor of AKI. Methods: We retrospectively enrolled 533 hospitalized elderly patients (aged ≥ 65 years) who checked the creatinine during admission for a period of 1 year (2013) and conducted a comprehensive geriatric assessment (CGA) within 1 year before AKI. We examined five variables (activity of daily living [ADL] and instrumental ADL dependence, dementia, nutrition, and polypharmacy) from CGA. We categorized the patients into 3 groups according to the tertile of aggregate frailty scores: Group 1, score 1–2; Group 2, score 3–4; Group 3, score 5–8). Results: Fifty-four patients (10.1%) developed AKI (median duration, 4 days). The frailest group (Group 3) showed an increased risk of AKI as compared to Group 1, (hazard ratio [HR] = 3.536, P = 0.002). We found that discriminatory accuracy for AKI improved with the addition of the tertile of aggregate frailty score to covariates (area under the receiver operator characteristics curves [AUROC] 0.641, AUROC 0.739, P = 0.004). Forty-six patients (8.6%) were transferred to nursing facilities and 477 patients (89.5%) were discharged home. The overall 90-day and 1-year mortality for elderly inpatients were 7.9% and 26.3%. The frailest group also demonstrated an increased risk of discharge to nursing facilities, and 90-day and 1-year mortality as compared to Group 1, independent of AKI severity (nursing facilities: odd ratio = 4.843, P = 0.002; 90-day mortality: HR = 6.555, P = 0.002; 1-year mortality: HR = 3.249, P = 0.001). Conclusion: We found that frailty, functional evaluation, may independently predict the development of AKI and adverse outcomes in geriatric inpatients.
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