Association of acute kidney injury with in-hospital outcomes among patients with delirium tremens: a national retrospective study

Background Acute kidney injury (AKI) may worsen outcomes of delirium tremens (DT), but data are limited. We investigated the association between AKI and hospital outcomes in DT and identified factors associated with AKI.Methods We conducted a retrospective observational study using the National Inpatient Sample (2017–2022) and ICD-10 codes. Adult hospitalizations with a principal diagnosis of DT were identified and stratified by AKI as a secondary diagnosis. Primary outcomes were endotracheal intubation rate, hospital length of stay, and all-cause hospital mortality. Multivariate regression, inverse probability of treatment weighting, and augmented inverse probability weighting were performed.Results Among 267,375 DT hospitalizations, 11.26% had AKI. Patients with AKI had longer length of stay (9.09 vs 5.88 days), a higher endotracheal intubation rate (13.62% vs 5.04%), and a higher hospital mortality rate (2.23% vs 0.28%) (all P < 0.001). In adjusted analyses, AKI was independently associated with increased odds of mortality (odds ratio [OR] 4.21) and intubation (OR 2.33), as well as longer hospital length of stay (all P < 0.001). These findings were consistent after weighting analyses. AKI was associated with male sex, Black race, sepsis, obesity, and higher Charlson Comorbidity Index.Conclusions AKI is common among patients hospitalized with DT and is associated with worse hospital outcomes.