Risk factors and outcome of acute kidney injury after congenital heart surgery: A prospective observational study

Amini, S. and Abbaspour, H. and Morovatdar, N. and Robabi, H. N. and Soltani, G. and Tashnizi, M. A. (2017) Risk factors and outcome of acute kidney injury after congenital heart surgery: A prospective observational study. Indian Journal of Critical Care Medicine, 21 (12). pp. 847-851.

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Backgrounds and Aims: Acute kidney injury (AKI) is a frequent event after congenital heart surgery with increased mortality and morbidity. We investigated frequency, risk factors, and associated morbidity and mortality of AKI after pediatric cardiac surgery at a single institution. Methods: Children undergoing congenital heart surgery from March 2013 to February 2016 were assessed for development of AKI based on modified pediatric Risk, Injury, Failure, Loss, and End-stage renal disease criteria. They were also investigated for predictive risk factors, associated mortality, and morbidity including duration of mechanical ventilation, Intensive Care Unit (ICU), and hospital length of stay. Results: Five hundred and nineteen patients were recruited during the study period including 259 (49.9) males and 260 (50.1) females. AKI was seen in 150 (28.9) patients including 101 (67.3), 42 (28), and 7 (4.7) cases with risk, injury, and failure stages, respectively. Patients with AKI had longer ventilation time (P = 0.002), ICU (P = 0.05), and hospital (P = 0.56) stay. Mortality was seen in 31 (2.7) and 44 (11.9) patients with and without AKI, respectively (P = 0.01). After multivariable logistic regression, there was an association between AKI and preoperative abnormal levels of creatinine (adjusted odds ratio aOR = 0.47, 95% confidence interval CI 0.22-1.01; P = 0.05), presence of cyanotic heart disease (aOR = 1.97, 95% CI = 1.15-3.2; P = 0.01), duration of surgery (aOR = 1.05/10 min, 95% CI = 1.01-1.08; P = 0.007), and elevated lactate level (aOR = 1.14, 95% CI = 1.03-1.3; P = 0.01). Conclusion: The presence of cyanotic heart disease, duration of surgery, elevated postoperative lactate level, and likely preoperative creatinine level were independent risk factors for the development of AKI after congenital heart surgery. © 2017 Indian Journal of Critical Care Medicine | Published by Wolters Kluwer-Medknow.

Item Type: Article
Additional Information: Cited By :3 Export Date: 16 February 2020 Correspondence Address: Amini, S.; Department of Anesthesiology and Critical Care, Cardiac Anesthesia Research Center, Mashhad University of Medical Sciences, Ebnesina Street, Iran; email: aminish@mums.ac.ir
Uncontrolled Keywords: Acute kidney injury congenital heart surgery outcome prediction creatinine dobutamine dopamine epinephrine hemoglobin lactic acid milrinone noradrenalin phenylephrine acute kidney failure adolescent aortic arch surgery aortic coarctation aortic valve repair aortic valve replacement arterial trunk Article artificial ventilation atrioventricular canal cardiopulmonary bypass child congenital heart disease creatinine blood level cyanotic heart disease estimated glomerular filtration rate female Fontan procedure forward heart failure Glenn shunt heart atrium septum defect heart surgery heart ventricle septum defect hemodialysis human infant intensive care unit lactate blood level length of stay lung artery banding major clinical study male mitral valve repair mitral valve replacement morbidity mortality newborn observational study outcome assessment preoperative evaluation prospective study pulmonary hypertension pulmonary valve replacement pulmonary valve stenosis risk factor treatment duration tricuspid valve repair tricuspid valve replacement urine volume
Subjects: WG Cardiovascular System
WJ Urogenital System
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib3 lib3
Date Deposited: 18 May 2020 06:49
Last Modified: 18 May 2020 06:49
URI: http://eprints.mums.ac.ir/id/eprint/16743

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