Risk factors and outcome of acute kidney injury after isolated cabg surgery: A prospective cohort study

Amini, S. and Najafi, M. N. and Karrari, S. P. and Mashhadi, M. E. and Mirzaei, S. and Tashnizi, M. A. and Moeinipour, A. A. and Hoseinikhah, H. and Aazami, M. H. and Jafari, M. (2019) Risk factors and outcome of acute kidney injury after isolated cabg surgery: A prospective cohort study. Brazilian Journal of Cardiovascular Surgery, 34 (1). pp. 70-75.

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Abstract

Background: Acute kidney injury (AKI) is a frequent event after cardiac surgery with increased mortality and morbidity. We explored frequency, risk factors, and associated morbidity and mortality of AKI after isolated coronary artery bypass grafting (CABG) surgery at a single institution. Methods: All consecutive adults undergoing CABG surgery from March 2013 to October 2016 were assessed for development and severity of AKI based on Acute Kidney Injury Network (AKIN) criteria. The patients were also investigated regarding their need for renal replacement therapy (RRT), predictive risk factors, and associated outcomes, including duration of mechanical ventilation, mortality, intensive care unit (ICU) and hospital length of stay. Results: Of 1737 patients in the study, 275 (15.8) developed AKI. Twenty-five (12.8) cases required RRT. Patients with AKI had longer ventilation time, ICU and hospital length of stay (P<0.001). Mortality rates were 28 (10.2) and 22 (1.5) in patients with and without AKI, respectively (P<0.001). There was a strong association between advanced age (aOR=1.016, 95 CI=1.002-1.030, P=0.028), diabetes (aOR=1.36, 95 CI=1.022-1.809, P=0.035), on-pump surgery (aOR=2.63, 95 CI=1.543-4.483, P<0.001), transfusion of more than 1 unit of red blood cells (aOR=2.154, 95 CI=1.237-3.753, P=0.007), and prolonged mechanical ventilation and development of AKI (aOR=2.697, 95 CI=1.02407.071, P<0.001). AKI was seen less frequently in those with opium abuse (aOR=0.613, 95 CI=0.409-0.921, P=0.018). Conclusion: We demonstrated that advanced age, diabetes, on-pump surgery, red blood cell transfusion, and prolonged mechanical ventilation were independent positive risk factors for the development of AKI after isolated CABG while opium abuse was a protective factor. © 2019, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

Item Type: Article
Additional Information: Cited By :1 Export Date: 16 February 2020 Correspondence Address: Amini, S.; Emam Reza Hospital Cardiac Anesthesia Research Center, Department of Anesthesiology and Critical Care Ebne, Sina Street, Iran; email: aminish@mums.ac.ir
Uncontrolled Keywords: Acute Kidney Injury Coronary Artery Bypass Treatment Outcome acute kidney failure aged artificial ventilation coronary artery bypass graft female hospital mortality human intensive care unit length of stay male middle aged mortality multivariate analysis nonparametric test pregnancy procedures prospective study reference value risk assessment risk factor statistics and numerical data time factor Humans Intensive Care Units Prospective Studies Reference Values Respiration, Artificial Risk Factors Statistics, Nonparametric Time Factors
Subjects: WJ Urogenital System
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib1 lib1
Date Deposited: 21 Jun 2020 04:21
Last Modified: 21 Jun 2020 04:21
URI: http://eprints.mums.ac.ir/id/eprint/18250

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