Key result
Postoperative red blood cell transfusion, age older than 80 years, and low cardiac output syndrome were identified as strong independent predictors of acute kidney insufficiency after isolated CABG.
Why the study?
Despite advances in cardiac surgery, the incidence of acute kidney insufficiency after isolated coronary artery bypass grafting surgery is increasing, prompting the need to identify its predictors.
Cohort (n=1,914)
No
Answers are grounded in this paper and cite their sources.
Postoperative acute kidney insufficiency after isolated CABG is significantly predicted by older age, diabetes, peripheral vascular disease, severe heart failure symptoms, surgical re-exploration, RBC transfusion, and low cardiac output syndrome.
Despite the advances of cardiac surgery in the last decades, the incidence of acute kidney insufficiency (AKI) post isolated coronary artery bypass grafting surgery (iCABG) is increasing. The purpose of this study was to identify the potential predictors of postoperative AKI in iCABG in order to implement measures to reduce its incidence. We reviewed the data of 1914 patients who had on-pump iCABG from January 2008 to December 2015, using the cardiothoracic surgery unit database of Liverpool Hospital, Sydney, New South Wales, Australia. Patients were divided into two groups according to the occurrence of postoperative AKI. The incidence of postoperative AKI was 5.3% in 8 years ( n = 101/1914 patients). Multivariable analysis has identified the following independent predictors of postoperative AKI; age older than 80 years (OR 4.27; 95% CI 1.6–11.81) ( p < 0.005), diabetes mellitus (OR 1.96; 95% CI 1.073–3.65) ( p = 0.034), peripheral vascular disease (OR 2.55; 95% CI 1.16–5.59) ( p < 0.01), severe congestive cardiac symptoms (i.e., NYHA III & IV) (OR 1.9; 95% CI 1.26–2.92) ( p = 0.002), surgical re-exploration (OR 2.49; 95% CI 1.07–5.76) ( p = 0.04), postoperative red blood cell (RBC) transfusion (OR 4.93; 95% CI 2.25–10.80) ( p < 0.0001), and postoperative low cardiac output syndrome (OR 2.85; 95% CI 1.49–5.46) ( p < 0.0001). Postoperative AKI after iCABG is a complex problem. Predictors of postoperative AKI can be mitigated by accurate risk-based assessment and intraoperative proper surgical hemostasis.
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Aty et al. (2019) conducted a cohort in Acute kidney insufficiency (n=1,914). Postoperative red blood cell (RBC) transfusion vs. No postoperative RBC transfusion was evaluated on Postoperative acute kidney insufficiency (AKI) (OR 4.93, 95% CI 2.25-10.80, p=<0.0001). Postoperative red blood cell transfusion, age older than 80 years, and low cardiac output syndrome were identified as strong independent predictors of acute kidney insufficiency after isolated CABG.
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