| アブストラクト | BACKGROUND: Previous studies examining vancomycin-associated acute kidney injury (AKI) were methodologically limited. We herein investigated the AKI incidence, clinical outcomes, and economic impact of this condition on Japan's aging population using a robust, methodological approach to analyze information from two, large-scale, Japanese, healthcare databases. METHODS: This retrospective cohort study analyzed data on 2007 and 2607 patients aged >/=18 years and registered with the Medical Data Vision (MDV) database and the JMDC, Inc. database, respectively, who received vancomycin >/=4 days. Target trial emulation was employed with 1:1 propensity score matching to compare the outcomes of patients with and without AKI. The primary outcomes included 30-day in-hospital mortality, length of hospital stay (LOS), and direct medical costs. The KDIGO guidelines' definition of AKI was used. RESULTS: AKI occurred in 19.4 % (MDV) and 14.9 % (JMDC) of the cohorts with the median onset being five days. After propensity score matching (386 and 387 pairs for MDV and JMDC, respectively), the AKI group demonstrated significantly higher 30-day in-hospital mortality (odds ratio: 3.82 [95 % confidence interval (CI): 2.52-5.79] for MDV; 4.36 [95 % CI: 2.89-6.57] for JMDC; both P < .001), prolonged LOS (hazard ratio: 1.45 [95 % CI: 1.22-1.72] for MDV; 1.79 [95 % CI: 1.35-2.37] for JMDC; both P < .001), and higher daily direct medical costs per patient (cost ratio: 1.39 [95 % CI: 1.19-1.62] for MDV; 1.33 [95 % CI: 1.18-1.50] for JMDC; both P < .001). CONCLUSIONS: Vancomycin-associated AKI significantly increased mortality, prolonged hospitalization, and elevated healthcare costs. These findings can provide further impetus to effective vancomycin stewardship. |
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| ジャーナル名 | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy |
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| Pubmed追加日 | 2025/6/6 |
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| 投稿者 | Murakami, Shutaro; Ishiyama, Azusa; Otogawa, Sayuri; Sakai, Ryoko; Akazawa, Manabu |
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| 組織名 | Department of Pharmacy, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan;;Department of Public Health and Epidemiology, Meiji Pharmaceutical University,;Tokyo, Japan. Electronic address: shuutarou_murakami@tmhp.jp.;Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40472935/ |
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