Cardiopulmonary bypass time is an independent risk factor for acute kidney injury in emergent thoracic aortic surgery: a
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(2019) 14:90
RESEARCH ARTICLE
Open Access
Cardiopulmonary bypass time is an independent risk factor for acute kidney injury in emergent thoracic aortic surgery: a retrospective cohort study Shijun Xu1, Jie Liu2, Lei Li1, Zining Wu1, Jiachen Li1, Yongmin Liu1, Junming Zhu1, Lizhong Sun1, Xinliang Guan1*, Ming Gong1* and Hongjia Zhang1*
Abstract Background: Thoracic aortic surgery and cardiopulmonary bypass are both associated with development of postoperative acute kidney injury. In this study, we undertook to investigate the relationship between cardiopulmonary bypass time and postoperative acute kidney injury in patients undergoing thoracic aortic surgery for acute DeBakey Type I aortic dissection. Methods: All patients receiving thoracic aortic surgery for acute DeBakey Type I aortic dissection in Beijing Anzhen hospital from December 2015 to April 2017 were included. Cardiopulmonary bypass time was recorded during surgery. Acute kidney injury was defined based on the Kidney Disease Improving Global Outcomes criteria. A total of 115 consecutive patients were eventually analyzed. Results: The overall incidence of acute kidney injury was 53.0% (n = 61). The average age was 47.8 ± 10.7 years; 74. 8% were male. Mean cardiopulmonary bypass time was 211 ± 56 min. In-hospital mortality was 7.8%. Multivariate logistic regression revealed that cardiopulmonary bypass time was independently associated with the occurrence of postoperative acute kidney injury after adjust confounding factors (odds ratio = 1.171; 95% confidence interval: 1. 002–1.368; P = 0.047). Conclusions: Cardiopulmonary bypass time is independently associated with an increased hazard of acute kidney injury after thoracic aortic surgery for acute DeBakey Type I aortic dissection. Further understanding of the mechanism of this association is crucial to the design of preventative strategies. Keywords: Acute kidney injury, Aortic dissection, Cardiopulmonary bypass, Risk factor, Thoracic aortic surgery
Introduction Acute kidney injury (AKI) is frequent as a serious complication following operation for acute DeBakey Type I aortic dissection (ADTIAD). But, the reported incidence of AKI following operation for ADTIAD varies extensively (20 to 67%), because the definition of AKI is * Correspondence: [email protected]; [email protected]; [email protected] 1 Department of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Lab for Cardiovascular Precision Medicine, and Beijing Engineering Research Center of Vascular Prostheses, No.2 Anzhen Street, Beijing 100029, China Full list of author information is available at the end of the article
different among studies, which is mildly higher than the incidences following other cardiac operations [8, 34, 36, 38, 40]. Furthermore, 2 to 8% of patients need renal replacement therapy (RRT) following aortic surgery [1, 2, 9, 10, 19, 20], which is related to an elevated short-term death rate of up
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