The Effect of Body Mass Index on Outcomes of In-Hospital Mortality, Hospital Utilization and Costs in Acute Kidney Injury Hospitalizations: An Analysis of the HCUP NIS Data
dc.contributor.advisor | Calhoun, Elizabeth | |
dc.contributor.advisor | Ojo, Akinlolu | |
dc.contributor.author | Mamven, Manmak Helen | |
dc.creator | Mamven, Manmak Helen | |
dc.date.accessioned | 2021-12-14T23:08:03Z | |
dc.date.available | 2021-12-14T23:08:03Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Mamven, Manmak Helen. (2021). The Effect of Body Mass Index on Outcomes of - In Hospital Mortality, Hospital Utilization and Costs in Acute Kidney Injury Hospitalizations: An Analysis of the HCUP NIS Data (Doctoral dissertation, University of Arizona, Tucson, USA). | |
dc.identifier.uri | http://hdl.handle.net/10150/662559 | |
dc.description.abstract | High and low Body Mass Index (BMI) are considered independent risk factors for mortality, longer lengths of hospital stay (LOS), and higher hospital cost compared to normal BMI even in Acute Kidney Injury patients (AKI). Race and ethnicity may play a role in modifying the outcomes. The aim of this study was to examine the relationship between BMI and all cause in-hospital mortality, hospital length of stay and hospital cost amongst AKI hospitalizations and to further assess in relation to race and ethnicity. The study used discharge data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality from 2013 through 2017. The design was a retrospective cohort study. AKI related hospitalizations in adult patients were identified using the ICD 9-CM and ICD 10-CM revision diagnostic codes. The BMI, the exposure of interest was classified into seven categories. Interaction was assessed between BMI and race for all the outcomes. A total of 679,756 patients with AKI related hospitalizations were analyzed. Compared to BMI 19-24.9kg/m 2, the adjusted risks of in-hospital mortality were, 1.28 (95%CI: 1.23-1.33), 0.71(95%CI: 0.67, 0.74), 0.54 (95%CI: 0.51, 0.56), 0.50 (95%CI: 0.48, 0.53), 0.56 (95%CI: 0.54, 0.58), 0.68 (95%CI: 0.64, 0.70) in the BMI categories, <19, 25-29.9, 30-34.9, 35-39.9, 40-49.9 and 50&above kg/m2 respectively. The risks were significantly different in the BMI categories. The median length of hospital stays tended to be higher in the BMI < 19 kg/m2 (6 IQR: 4,10 days), and in the BMI >50 & above kg/m2 (6 IQR: 4,10 days) while the median hospital cost was highest in the > 50 kg/m2 BMI category (12,643.97 IQR:7,253.18-23,630.4 USD). Significant interactions between BMI and race were observed for mortality, LOS, and Hospital cost. This large and nationally representative sample of hospitals in the USA, provided further evidence for the obesity paradox, which whether due to plausible biological reactions or to methodological errors still remains controversial. Estimating LOS and hospital costs of AKI hospitalizations according to BMI and with race/ethnicity in view, are important to the payers of healthcare, employers, and government agencies to determine the cost effectiveness of processes and interventions that may reduce poor outcomes. | |
dc.language.iso | en | |
dc.publisher | The University of Arizona. | |
dc.rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction, presentation (such as public display or performance) of protected items is prohibited except with permission of the author. | |
dc.rights.uri | http://rightsstatements.org/vocab/InC/1.0/ | |
dc.subject | Acute Kidney Injury Hospitalization | |
dc.subject | Body Mass Index | |
dc.subject | HCUP NIS DATA | |
dc.subject | Hospital Cost | |
dc.subject | Hospital Utilization | |
dc.subject | Mortality | |
dc.title | The Effect of Body Mass Index on Outcomes of In-Hospital Mortality, Hospital Utilization and Costs in Acute Kidney Injury Hospitalizations: An Analysis of the HCUP NIS Data | |
dc.type | text | |
dc.type | Electronic Dissertation | |
thesis.degree.grantor | University of Arizona | |
thesis.degree.level | doctoral | |
dc.contributor.committeemember | Brosius, Frank | |
dc.contributor.committeemember | Roe, Denise | |
dc.description.release | Release after 06/07/2022 | |
thesis.degree.discipline | Graduate College | |
thesis.degree.discipline | Clinical Translational Sciences | |
thesis.degree.name | Ph.D. | |
dc.description.admin-note | Replaced title page with corrected title page supplied by author on 12-Jan-2022, Kimberly. |