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dc.contributor.authorKolhe, Nitin
dc.contributor.authorFluck, Richard
dc.contributor.authorTaal, Maarten
dc.date.accessioned2016-10-25T09:59:45Z
dc.date.available2016-10-25T09:59:45Z
dc.date.issued2016-10
dc.identifier.citationPLoS One. 2016 Oct 17;11(10):e0162856. doi: 10.1371/journal.pone.0162856. eCollection 2016.language
dc.identifier.urihttp://hdl.handle.net/20.500.12904/641
dc.description.abstractBACKGROUND: The absence of effective interventions in presence of increasing national incidence and case-fatality in acute kidney injury requiring dialysis (AKI-D) warrants a study of regional variation to explore any potential for improvement. We therefore studied regional variation in the epidemiology of AKI-D in English National Health Service over a period of 15 years. METHOD: We analysed Hospital Episode Statistics data for all patients with a diagnosis of AKI-D, using ICD-10-CM codes, in English regions between 2000 and 2015 to study temporal changes in regional incidence and case-fatality. RESULTS: Of 203,758,879 completed discharges between 1st April 2000 and 31st March 2015, we identified 54,252 patients who had AKI-D in the nine regions of England. The population incidence of AKI-D increased variably in all regions over 15 years; however, the regional variation decreased from 3·3-fold to 1·3-fold (p<0·01). In a multivariable adjusted model, using London as the reference, in the period of 2000-2005, the North East (odd ratio (OR) 1·38; 95%CI 1·01, 1·90), East Midlands (OR 1·38; 95%CI 1·01, 1·90) and West Midlands (OR 1·38; 95%CI 1·01, 1·90) had higher odds for death, while East of England had lower odds for death (OR 0·66; 95% CI 0·49, 0·90). The North East had higher OR in all three five-year periods as compared to the other eight regions. Adjusted case-fatality showed significant variability with temporary improvement in some regions but overall there was no significant improvement in any region over 15 years. CONCLUSIONS: We observed considerable regional variation in the epidemiology of AKI-D that was not entirely attributable to variations in demographic or other identifiable clinical factors. These observations make a compelling case for further research to elucidate the reasons and identify interventions to reduce the incidence and case-fatality in all regions.language
dc.language.isoenlanguage
dc.subjectAcute Kidney Injurylanguage
dc.subjectDialysislanguage
dc.subjectEpidemiologylanguage
dc.titleRegional Variation in Acute Kidney Injury Requiring Dialysis in the English National Health Service from 2000 to 2015 - A National Epidemiological Study.language
dc.typeArticlelanguage
refterms.dateFOA2021-06-03T10:09:22Z


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