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Impact of postoperative acute kidney injury on short-term outcomes of patients with Bentall surgery for any reason

医学 急性肾损伤 优势比 单变量分析 外科 心脏外科 回顾性队列研究 心肌梗塞 内科学 多元分析
作者
Julia Merkle,Ilija Djordjevic,Christopher Gaisendrees,Borko Ivanov,Carolyn Weber,Ihor Krasivskyi,Soi Avgeridou,Mariya Mihaylova,Navid Mader,Ferdinand Kuhn‐Régnier,Anton Sabashnikov,Thorsten Wahlers
出处
期刊:Perfusion [SAGE]
卷期号:38 (3): 631-636
标识
DOI:10.1177/02676591211073865
摘要

Acute kidney injury (AKI) after cardiac surgery is a well-known risk factor for increased postoperative mortality and morbidity. The effect of postoperative developed AKI on postoperative outcomes in patients after Bentall procedure has been incompletely investigated. The present study was dedicated to assessing the impact of postoperative AKI on morbidity and 30-day mortality in this specific cohort.In a retrospective observational study, we investigated 249 patients undergoing Bentall procedure from January 2014 to March 2018 at the University Hospital of Cologne, Germany. After excluding patients with preoperative renal impairment, patients were divided into an AKI group (n = 88) and a non-AKI group (n = 97). Postoperative outcomes and 30-day mortality were analyzed using univariate regression analysis. AKI was defined by AKIN criteria.Mortality during ICU and hospital stay, as well as 30-day mortality, was significantly higher in the AKI group (all p < 0.001). Patients with postoperative developed AKI revealed 9.3-fold higher odds for ICU mortality and 6.7-fold higher odds for 30-day mortality in comparison to non-AKI group (all p < 0.004) as well as 4.5-fold higher odds for stroke. Coronary artery bypass time, as well as cross-clamp time, were similarly distributed between groups, whereas incidences of postoperative bleeding, myocardial infarction, and need for rethoracotomy occurred significantly more often in patients with postoperatively developed AKI (all p < 0.04).Patients undergoing Bentall surgery who postoperatively developed AKI showed significantly higher morbidity and mortality. AKI points out to be an early predictor for poor outcomes. Thus, as a consequence, patients with postoperatively developed AKI should be highly monitored for immediate intervention.
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