Risk factors and outcome of acute kidney injury after isolated cabg surgery: a prospective cohort study
Rev. bras. cir. cardiovasc
; Rev. bras. cir. cardiovasc;34(1): 70-75, Jan.-Feb. 2019. tab
Article
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| ID: biblio-985236
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ABSTRACT
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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Ponte de Artéria Coronária
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Injúria Renal Aguda
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Pregnancy
Idioma:
En
Revista:
Braz. j. cardiovasc. surg. (impr.)
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Brazilian journal of cardiovascular surgery
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Rev Bras Cir Cardiovasc
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Rev. bras. cir. cadiovasc. (Online)
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Rev. bras. cir. cardiovasc
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Revista brasileira de cirurgia cardiovascular
Assunto da revista:
CARDIOLOGIA
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CIRURGIA GERAL
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Irã
/
Estados Unidos
País de publicação:
Brasil