Key result
Higher serum creatinine levels were independently associated with increased in-hospital mortality among patients readmitted to the ICU after cardiac surgery (OR 1.14; 95% CI 1.07-1.25).
Why the study?
Patients readmitted to the ICU after cardiac surgery have high mortality, but the relationship between renal function and in-hospital mortality in these patients has not been well demonstrated.
Do serum creatinine and eGFR levels predict in-hospital mortality in patients readmitted to the ICU after cardiac surgery?
Cohort (n=184)
Do serum creatinine and eGFR levels predict in-hospital mortality in patients readmitted to the ICU after cardiac surgery?
Odds Ratio: 1.14 (95% CI 1.07–1.25)
Elevated serum creatinine and lower eGFR at the time of ICU readmission after cardiac surgery are independent predictors of in-hospital mortality.
May inform risk stratification at post-cardiac surgery ICU readmission; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: Patients readmitted to the intensive care unit (ICU) after cardiac surgery have a high mortality rate. The relationship between renal function and in-hospital mortality in readmitted patients has not been well demonstrated. METHODS: We retrospectively evaluated cardiac surgery patients who were readmitted to the ICU at least once. Data on serum creatinine levels before surgery and on the day of ICU readmission were collected. The estimated glomerular filtration rate (eGFR) was calculated according to the creatinine-based Chronic Kidney Disease-Epidemiology Collaboration equation. We used logistic regression models and restricted cubic spline curves with four knots (5%, 35%, 65%, 95%) to investigate the relationship between renal function indicators and mortality. RESULTS: Of the 184 patients evaluated, 30 patients died during hospitalization, yielding a mortality rate of 16.30%. Cardiac dysfunction (n=84, 45.65%) and respiration disorder (n=51, 27.72%) were the most common reasons for ICU readmission. Creatinine [odds ratio (OR): 1.14, 95% confidence interval (CI): 1.07-1.25] and eGFR (OR: 0.95, 95% CI: 0.93-0.98) were independently associated with in-hospital mortality after adjusting for various confounders. Both creatinine level and eGFR had a linear association with in-hospital mortality (P for non-linearity ˃0.05). CONCLUSION: Renal function is significantly associated with the in-hospital mortality of patients readmitted to the ICU after cardiac surgery, as evidenced by the independent correlation of both creatinine and eGFR with in-hospital mortality.
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Zhong et al. (2021) conducted a cohort in ICU readmission after cardiac surgery (n=184). Serum creatinine was evaluated on In-hospital mortality (OR 1.14, 95% CI 1.07-1.25). Higher serum creatinine levels were independently associated with increased in-hospital mortality among patients readmitted to the ICU after cardiac surgery (OR 1.14; 95% CI 1.07-1.25).
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