Acute kidney injury is associated with higher morbidity and resource utilization in pediatric patients undergoing heart surgery.
Ann Thorac Surg
; 93(6): 1984-90, 2012 Jun.
Article
de En
| MEDLINE
| ID: mdl-22226235
ABSTRACT
BACKGROUND:
The RIFLE (risk, injury, failure, loss, and end-stage renal disease) classification system was developed to standardize the definition of acute kidney injury (AKI) in adults. We hypothesized that AKI was associated with increased mortality and morbidity.METHODS:
Acute kidney injury was defined as a decrease in the amount of estimated creatinine clearance based on pediatric-modified RIFLE (pRIFLE) criteria. Using propensity score analysis, 325 patients who had AKI were matched to 325 patients who did not have AKI from a database of 1,510 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between AKI and outcome was analyzed after propensity score matching of perioperative variables.RESULTS:
Four hundred eighty-one patients (31.9%) had AKI according to the RIFLE categories. Of those 1,510, 173 (11.5%) reached pRIFLE criteria for risk; 26 (1.7%) reached the criteria for injury; and 282 (18.7%) reached the criteria for failure. Fifty-five patients (3.6%) died. The 2 matched groups were well balanced in terms of measured perioperative variables. Mortality rate was 5.2% in the AKI and 2.5% in the matched control group (p=0.09). Occurrence of low cardiac output syndrome (p=0.002), need for dialysis (p<0.001), and infection (p=0.03) were significantly higher, and duration of mechanical ventilation (p<0.001) and length of intensive care unit stay (p<0.001) were significantly longer compared with the matched control group.CONCLUSIONS:
Acute kidney injury was independently associated with an increased occurrence of postoperative complications but not with mortality after pediatric cardiac surgery.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Complications postopératoires
/
Atteinte rénale aigüe
/
Ressources en santé
/
Cardiopathies congénitales
Type d'étude:
Risk_factors_studies
Limites:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Langue:
En
Journal:
Ann Thorac Surg
Année:
2012
Type de document:
Article
Pays d'affiliation:
Hongrie