The relation between preoperative thyroid function and postoperative AKI in patients with ASTAAD / 中华胸心血管外科杂志

ABSTRACT

Objective:To evaluate the association between preoperative thyroid hormones and the postoperative acute kidney injury (AKI) in acute Standford type A aortic dissection (ASTAAD) patients.Methods:The patients with ASTAAD, who underwent surgeries in Beijing Anzhen Hospital from July 2016 to December 2016, were included in this retrospective cohort study. Multivariable regression and stratification analyses were used to examine the association of preoperative thyroid hormone with postoperative AKI.Results:The overall occurrence of postoperative AKI was 42.0%. Multivariate regression revealed that low level of TT3 ( OR=0.08, 95% CI 0.01-0.94, P=0.04) and TT4 ( OR=0.97, 95% CI 0.94-1.00, P=0.04) was independently associated with postoperative AKI. Subgroup analyses showed that the relation between TT3 and AKI was significantly noticed in patients with normal TSH levels ( OR=0.004, 95% CI 0.001-0.16, P<0.01) other than in patients with lower TSH levels ( P=0.26). Conclusion:The present study showed that a low level of TT3 or TT4 was a predictor of postoperative AKI in ASTAAD patients, especially in patients with normal TSH. The thyroid function should be checked before surgical intervention of patients with ASTAAD, and patients with low T3 might be at higher risk of postoperative AKI.