Acute XXXX and @entity8 : a high-risk combination.

@entity1 @entity8 @entity117 @entity740 @entity177 @entity1011 @entity583 @entity204 @entity454
BACKGROUND: Survival is poor in @entity1 with acute @entity583 ( @entity583 ) who also have severe @entity8 . Less is known about the outcome of @entity583 in @entity1 with mild to moderate @entity177 . OBJECTIVE: To compare outcomes after @entity583 in @entity1 with varying levels of @entity8 and in @entity1 without @entity177 . DESIGN: Retrospective cohort study. SETTING: Academic medical center. @entity1 : 3106 total @entity1 admitted with @entity583 and @entity454 (n = 44), severe @entity177 ( @entity1011 clearance < 0.59 mL/s [<35 mL/min]) (n = 391), moderate @entity8 ( @entity1011 clearance > or = 0.59 mL/s [<35 mL/min] but < or =0.84 mL/s [< or =50 mL/min]) (n = 491), mild @entity740 ( @entity1011 clearance > 0.84 mL/s [>50 mL/min] but < or =1.25 mL/s [< or =75 mL/min]) (n = 860), or no @entity8 (n = 1320). MEASUREMENTS: Clinical characteristics, treatment strategies, and short- and long-term survival were compared after @entity1 were stratified by @entity1011 clearance. RESULTS: In-hospital mortality rates were 2% in @entity1 with normal renal function, 6% in those with mild @entity177 , 14% in those with moderate @entity177 , 21% in those with severe @entity177 , and 30% in those with @entity454 (P < 0.001). Compared with @entity1 without @entity8 , similar adjusted trends were present for postdischarge @entity204 in @entity1 with @entity454 (hazard ratio, 5.4 [95% CI, 3.0 to 9.7]; P < 0.001), severe @entity177 (hazard ratio, 1.9 [CI, 1.2 to 3.0]; P = 0.006), moderate @entity8 (hazard ratio, 2.2 [CI, 1.5 to 3.3]; P < 0.001), and mild @entity740 (hazard ratio, 2.4 [CI, 1.7 to 3.3]; P < 0.001). @entity1 with @entity177 received adjunctive and reperfusion therapies less frequently than those with normal renal function (P < 0.001). @entity204 was less likely in @entity1 who received acute reperfusion therapy (odds ratio, 0.7 [CI, 0.6 to 0.9]), @entity117 (odds ratio, 0.7 [CI, 0.5 to 0.8]), and beta-blocker therapy (odds ratio, 0.7 [CI, 0.6 to 0.9]). CONCLUSION: @entity1 with @entity177 are at increased risk for @entity204 after @entity583 and receive less aggressive treatment than @entity1 with normal renal function.
