Prognostic value of preoperative nutritional status for postoperative moderate to severe acute kidney injury among older patients undergoing coronary artery bypass graft surgery: a retrospective study based on the MIMIC-IV database

Autor: Peng Bao, Peng Qiu, Tao Li, Xue Lv, Junyu Wu, Shaojie Wu, Hao Li, Zhiping Guo
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Renal Failure, Vol 46, Iss 2 (2024)
Druh dokumentu: article
ISSN: 0886022X
1525-6049
0886-022X
DOI: 10.1080/0886022X.2024.2429683
Popis: Objective To investigate the association between preoperative nutritional scores and moderate-to-severe acute kidney injury (AKI) after coronary artery bypass graft (CABG) surgery and the predictive significance of nutritional indices for moderate to severe AKI.Methods This study retrospectively included older patients underwent CABG surgery from the Medical Information Mart for Intensive Care (MIMIC) database. Nutritional scores were calculated by the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI), respectively. Moderate-to-severe injury was determined by KDIGO criteria. Logistic regression, subgroup analysis, and restricted cubic splines were utilized to investigate the association. The predictive value was also assessed by the area under the curve (AUC), net reclassification index (NRI), and integrated discrimination improvement (IDI).Results A total of 1,007 patients were retrospectively included, of which 100 (9.9%) and 380 (37.7%) had malnutrition calculated by GNRI and PNI scores. The incidence of moderate-to-severe AKI was 524 (52.0%). After adjustment for selected risk factors, worse nutritional scores were associated with a higher incidence of moderate-to-severe AKI (PGNRI
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