Impact of Acute Kidney Injury on In-Hospital Outcomes in Patients With DeBakey Type III Acute Aortic Dissection
| Autor: | Yusuke Kabeya, Naoki Hirata, Toshiyuki Takahashi, Ayaka Endo, Tasuku Hasegawa, Yu Yamasaki, Susumu Nakagawa, Kenki Ashida |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Renal function urologic and male genital diseases Severity of Illness Index Electrocardiography chemistry.chemical_compound Japan Risk Factors medicine.artery Internal medicine Severity of illness medicine Humans Hospital Mortality Renal artery Survival rate Aged Retrospective Studies Aortic dissection Inpatients Creatinine Aortic Aneurysm Thoracic business.industry Incidence Incidence (epidemiology) Acute kidney injury Acute Kidney Injury Middle Aged Prognosis medicine.disease female genital diseases and pregnancy complications Survival Rate Aortic Dissection chemistry Echocardiography Cardiology Female Cardiology and Cardiovascular Medicine business Glomerular Filtration Rate |
| Zdroj: | The American Journal of Cardiology. 113:1904-1910 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2014.03.023 |
| Popis: | The relation between the incidence and severity of acute kidney injury (AKI) and clinical outcomes remains unclear in patients with DeBakey type III acute aortic dissection (AAD). We retrospectively assessed 56 patients admitted to our hospital for type III AAD within 48 hours of the onset of symptoms. The presence of AKI was identified, and its severity was staged on the basis of changes in serum creatinine (SCr) levels within 7 days after admission. We investigated the relations between AKI and clinical presentations, in-hospital complications, and predischarge renal function; AKI was observed in 20 patients (36%). After adjusting for age, gender, and body mass index, the incidence of AKI was associated with a history of hypertension, electrocardiographic ST-T changes, DeBakey type IIIb, and SCr level on admission. Maximum white blood cell count and serum C-reactive protein level were higher in patients with AKI than in those without AKI. AKI was associated with a greater incidence of in-hospital complications (70% vs 39%, p = 0.03) and higher SCr levels at discharge (1.1 [range 1.0 to 2.0] vs 0.9 [range 0.7 to 1.0] mg/dl, p = 0.0001). These associations were more pronounced in patients with relatively severe AKI. Multivariate analysis revealed that SCr level on admission and DeBakey type IIIb with renal artery involvement were major predictors of AKI. In conclusion, renal function on admission and renal artery involvement were significant risk factors for AKI, which was associated with poor outcomes and enhanced inflammatory response during hospitalization in patients with type III AAD. |
| Databáze: | OpenAIRE |
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