Predictors of Acute Kidney Injury Following Aortic Arch Surgery
| Autor: | Jay D. Pal, David A. Fullerton, T. Brett Reece, Muhammad Aftab, Joseph C. Cleveland, Christian V. Ghincea, Mohamed Eldeiry, Michael Jarrett, Michael Bronsert, Gavriel F. Roda |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Aorta Thoracic urologic and male genital diseases Logistic regression Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Postoperative Complications law Risk Factors Cardiopulmonary bypass Medicine Humans Blood Transfusion Hospital Mortality Risk factor Aged Retrospective Studies Cardiopulmonary Bypass urogenital system business.industry Incidence Acute kidney injury Acute Kidney Injury Middle Aged Aortic arch surgery medicine.disease Prognosis female genital diseases and pregnancy complications Surgery Circulatory Arrest Deep Hypothermia Induced Treatment Outcome 030220 oncology & carcinogenesis Circulatory system 030211 gastroenterology & hepatology Female business Complication Kidney disease |
| Zdroj: | The Journal of surgical research. 242 |
| ISSN: | 1095-8673 |
| Popis: | Acute kidney injury (AKI) following open aortic arch surgery is a frequent complication associated with increased morbidity and mortality. The primary purpose of this study was to evaluate risk factors for postoperative AKI in patients who underwent open aortic arch surgery utilizing hypothermic circulatory arrest (HCA).Included were 295 patients undergoing surgery between January 2011 and March 2018. AKI was defined according to Kidney Disease: Improving Global Outcomes guidelines. Preoperative and intraoperative variables were stratified by no AKI versus any AKI, and bivariate analysis was performed. Multivariable logistic regression analysis used statistically and clinically significant characteristics from the bivariate analysis.Of the 295 patients, 93 (32%) developed AKI. In the bivariate analysis, significant predictors of AKI included the following: history of hypertension (P 0.001), diabetes (P = 0.03), operative urgency (P = 0.009), cardiopulmonary bypass (CPB) time (P 0.0001), HCA time (0.02), total intraoperative transfusions (P = 0.002), and concomitant procedures (coronary artery bypass grafting, or mitral/tricuspid interventions, P = 0.0009). In the multivariable analysis, significant predictors of AKI were history of hypertension (P = 0.03) and CPB time (P = 0.02). Age, operative urgency, circulatory arrest time, and any intraoperative transfusion were not significant in the multivariable analysis.In conclusion, given that CPB time is the only modifiable risk factor identified in the analysis, approaches to reducing bypass time should continue to be the focus of decreasing risk for postoperative AKI in HCA cases. |
| Databáze: | OpenAIRE |
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