The Risk Factors and Outcomes of Acute Kidney Injury after Thoracic Endovascular Aortic Repair
| Autor: | Yun-Ho Jeon, Chi-Hoon Bae |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty lcsh:Surgery Thoracic endovascular aortic repair 030204 cardiovascular system & hematology urologic and male genital diseases law.invention 03 medical and health sciences 0302 clinical medicine Clinical Research law medicine Rifle 030212 general & internal medicine Stroke business.industry urogenital system Mortality rate Acute kidney injury Perioperative lcsh:RD1-811 medicine.disease RIFLE Intensive care unit female genital diseases and pregnancy complications Surgery Cardiology and Cardiovascular Medicine Paraplegia business Kidney disease |
| Zdroj: | Korean Journal of Thoracic and Cardiovascular Surgery, Vol 49, Iss 1, Pp 15-21 (2016) The Korean Journal of Thoracic and Cardiovascular Surgery |
| ISSN: | 2093-6516 |
| DOI: | 10.5090/kjtcs.2016.49.1.15 |
| Popis: | Background: We aimed to evaluate the incidence, predictive factors, and impact of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR). Methods: A total of 53 patients who underwent 57 TEVAR operations between 2008 and 2015 were reviewed for the incidence of AKI as defined by the RIFLE (risk, injury, failure, loss, and end-stage kidney disease risk) consensus criteria. The estimated glomerular filtration rate was determined in the perioperative period. Comorbidities and postoperative outcomes were retrospectively reviewed. Results: Underlying aortic pathologies included 21 degenerative aortic aneurysms, 20 blunt traumatic aortic injuries, six type B aortic dissections, five type B intramural hematomas, three endoleaks and two miscellaneous diseases. The mean age of the patients was 61.2±17.5 years (range, 15 to 85 years). AKI was identified in 13 (22.8%) of 57 patients. There was an association of preoperative stroke and postoperative paraparesis and paraplegia with AKI. The average intensive care unit (ICU) stay in patients with AKI was significantly longer than in patients without AKI (5.3 vs. 12.7 days, p=0.017). The 30-day mortality rate in patients with AKI was significantly higher than patients without AKI (23.1% vs. 4.5%, p=0.038); however, AKI did not impact long-term survival. Conclusion: Preoperative stroke and postoperative paraparesis and paraplegia were identified as predictors for AKI. Patients with AKI experienced longer average ICU stays and greater 30-day mortality than those without AKI. Perioperative identification of highrisk patients, as well as nephroprotective strategies to reduce the incidence of AKI, should be considered as important aspects of a successful TEVAR procedure. |
| Databáze: | OpenAIRE |
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