Moderate to Severe Acute Kidney Injury Leads to Worse Outcomes in Complex Thoracic Aortic Surgery.
Ann Thorac Surg
; 111(3): 872-880, 2021 03.
Article
en En
| MEDLINE
| ID: mdl-32771466
ABSTRACT
BACKGROUND:
The impact of acute kidney injury (AKI) in thoracic aortic surgery is not well defined. This study aimed to examine the impact of varying severity of AKI on in-hospital and long-term outcome in these patients.METHODS:
From 2004 to 2018, 1142 patients underwent thoracic aortic surgery at a single institution (University of Ottawa Heart Institute, Ottawa, Canada) and were stratified into 4 groups on the basis of the severity of postoperative AKI no AKI (n = 705), Acute Kidney Injury Network (AKIN) stage 1 (n = 261), AKIN stage 2 (n = 72), and AKIN stage 3 (n = 104). Outcomes include in-hospital mortality, morbidity, and long-term survival. Multivariable logistic regression was used to identify independent predictors of AKI. Propensity score matching was performed to identify pairs of patients without postoperative AKI or with AKIN stage 1 AKI, as well as pairs of patients without postoperative AKI and those with AKIN stage 2 or higher AKI. Kaplan-Meier curves were plotted for late survival.RESULTS:
In the propensity-matched cohort, patients with postoperative AKIN stage I AKI had worse in-hospital mortality but comparable long-term survival when compared with patients without postoperative AKI. Patients with AKIN stage 2 or higher AKI experienced significantly higher in-hospital mortality compared with patients without postoperative AKI (15.9% vs 4.6%; P < .01) and worse 8-year survival (65.9% ± 34.1% vs 80.1% ± 20.0%; P < .01).CONCLUSIONS:
Moderate to severe AKI is a serious complication and is associated with significantly worse short- and long-term outcomes; targeting mild AKI with therapeutic intervention is an important step in improving patient outcomes.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades de la Aorta
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Complicaciones Posoperatorias
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Procedimientos Quirúrgicos Vasculares
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Puntaje de Propensión
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Lesión Renal Aguda
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Ann Thorac Surg
Año:
2021
Tipo del documento:
Article
País de afiliación:
Canadá