Relationship Between Fall Risk and Risk of Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Multicenter Retrospective Study

Background: Acute kidney injury (AKI) is a frequent complication in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI), significantly increasing mortality. The Huaxi Fall Risk Assessment (H-FRA) scale, a multidimensional bedside tool, may indirectly reflect AKI risk through factors like impaired mobility and systemic vulnerability. This study investigated the association between H-FRA and AKI in AMI patients. Methods: This multicenter retrospective cohort study utilized data from 2,883 AMI patients treated with PCI across seven Chinese tertiary hospitals (January 2017 - February 2019). Patients were stratified into low, intermediate, and high fall-risk groups based on H-FRA tertiles at admission. Baseline serum creatinine was the first value measured upon admission. Multivariable logistic regression adjusted for confounders (age, sex, comorbidities, lab values). Predictive performance was assessed using receiver operating characteristic (ROC) curve analysis, sensitivity and specificity. Results: AKI incidence significantly increased across H-FRA groups (low-risk: 4.8%, intermediate-risk: 18.3%, high-risk: 41.3%, p < 0.001). After adjustment, high H-FRA risk was independently associated with AKI (adjusted odds ratio [OR] 2.12, 95% confidence interval [CI] 1.24– 3.92, p < 0.001). Each 1-point H-FRA increase raised AKI risk by 30% (OR 1.30, 95% CI 1.14– 1.48, p < 0.001). The H-FRA demonstrated moderate predictive performance (area under the curve [AUC] 0.731, 95% CI 0.714– 0.748, p < 0.0001). Conclusion: The H-FRA is independently associated with AKI in patients with AMI. The H-FRA may serve as a useful and simple bedside tool for identifying AMI patients at increased risk of AKI. However further prospective validation is required.