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PINC AI™ Data: Rising Healthcare Utilization and Costs Linked to Persistence of Severe Acute Kidney Injury


Acute Kidney Injury (AKI), an abrupt decrease in kidney function, affects 5-18 percent of all hospitalized adults and 20-74 percent of those admitted to an intensive care unit (ICU). Severe AKI that is persistent (lasting ≥ 3 days) can be associated with increased risk of chronic kidney diseases (CKD), mortality and other long-term adverse outcomes.1-4

Since severe AKI in hospitalized patients has the potential for serious adverse outcomes, clinicians are working hard to identify the risk factors and provide early intervention to help improve outcomes and reduce overall healthcare costs.

Enter Baxter International, Inc., bioMérieux and Premier Applied Sciences® (PAS, an instrumental part of the Premier’s technology and services platform, PINC AI).

Baxter, a global leader in acute care, and bioMérieux, a global leader in in vitro diagnostics, joined forces with PAS, the research and analytics division of Premier Inc. Together, they delved into the Premier® Healthcare Database (PHD) to seek real-world evidence on the consequences of persistent severe AKI in hospitalized patients.

Underpinning PAS’s healthcare improvement work is the PHD, comprised of over 20 years of de-identified data from more than 1,030 hospitals spanning multiple therapeutic and quality improvement areas. Currently, the PHD contains data from more than one billion inpatient and hospital-based outpatient encounters.

The Premier Applied Sciences -bioMérieux-Baxter Research Study

Utilizing data from the PHD, this retrospective real-world cohort study aimed to compare clinical outcomes, length of stay (LOS) and costs during initial hospitalization and 30-day follow-up between hospitalized patients with persistent severe AKI (PS-AKI) and those with non-persistent AKI (NPS AKI), overall, and stratified by ICU use during initial hospitalization. The study time was between Jan. 1, 2017 and Dec. 31, 2019, with 30-day follow-up outcomes and 365-day lookback for baseline serum creatinine level (SCr) and comorbidities assessment.

Researchers found:

  • Almost 25 percent of 126,528 hospitalized patients with severe (KDIGO stage 2/3) AKI developed PS-AKI (lasting ≥ 3 days), which was associated with substantially higher odds of death, longer LOS and higher costs during their initial hospitalization compared to NPS-AKI (presented at the European Society of Intensive Medicine’s (ESICM) annual conference, LIVES on October 4 and referenced here on page 20).
  • Compared to patients with NPS-AKI, patients with PS-AKI also had higher risk of readmission, death and dialysis, longer readmission LOS and higher readmission and outpatient costs during the 30-days after discharge from their initial hospitalization (presented at the International Symposium on Intensive Care & Emergency Medicine (ISICEM) in August).

The results of this study demonstrated the importance and value of identifying patients at risk and of PS-AKI.

The Power of Real-World Data and Insights

The PHD will continue to provide life sciences partners like Baxter and bioMérieux the opportunity to use real-world data to conduct evidence-based studies of clinical outcomes to improve the overall quality, safety and cost-effectiveness of care.

In addition to life sciences organizations, PAS partners with academia, government agencies, and healthcare insurers and providers, providing them with PHD data for analyses of drugs, devices, disease states, epidemiology, resource utilization, healthcare economics and clinical outcomes.

Learn more: Discover how the PHD is fueling research conducted by the PAS research team, the Centers for Disease Control, the National Institutes of Health and others.


1. Han SS et al. Duration of acute kidney injury and mortality in critically ill patients: a retrospective observational study. BMC Nephrol 2018; 14:133.

2. Perinel S et al. Transient and persistent acute kidney injury and the risk of hospital mortality in critically ill patients: results of a multicenter cohort study. Crit Care Med 2015; 43: e269-275.

3. Mehta S et al. The prognostic importance of duration of AKI: a systematic review and meta-analysis. BMC Nephrology 2018; 19:91.

4. Pannu M et al. Association between AKI, recovery of renal function, and long-term outcomes after hospital discharge. Clin J Am Soc Nephrol 2013; 8:194-202.

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