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The neutrophil to lymphocyte ratio and serum albumin as predictors of acute kidney injury after coronary artery bypass grafting. Sci Rep 2022; 12:15438. [PMID: 36104386 PMCID: PMC9475019 DOI: 10.1038/s41598-022-19772-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Postoperative acute kidney injury (AKI) is a highly prevalent and serious complication after cardiac surgery. The aim of this study is to identify the predictors of AKI and the cut-off values after isolated off-pump coronary artery bypass grafting (OPCAB). A total of 329 adult patients, who underwent isolated OPCAB between December 2008 and February 2021, were retrospectively analyzed. The patients were divided into three groups: non-AKI, early AKI and late AKI groups. The early AKI group or the late AKI group were defined as ‘having AKI that occurred before or after 48 h postoperatively’, respectively. Multivariate logistic regression analysis was performed to identify the predictors of AKI. Receiver operating characteristic (ROC) curve analysis was used to evaluate the cutoff value, the sensitivity, and the specificity of the predictors. On the multivariate analysis, the emergency surgery, the preoperative serum albumin, and the postoperative day 1 neutrophil to lymphocyte ratio (NL ratio) were identified as the independent predictors of AKI. However, neither albumin nor the NL ratio predicted late AKI. The present study showed the preoperative albumin and the postoperative day 1 NL ratio were the robust and independent predictors of postoperative early AKI in isolated OPCAB.
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Panagidi M, Papazoglou ΑS, Moysidis DV, Vlachopoulou E, Papadakis M, Kouidi E, Galanos A, Tagarakis G, Anastasiadis K. Prognostic value of combined preoperative phase angle and handgrip strength in cardiac surgery. J Cardiothorac Surg 2022; 17:227. [PMID: 36057619 PMCID: PMC9440499 DOI: 10.1186/s13019-022-01970-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/20/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Phase angle (PA) constitutes a bioelectrical impedance measurement, indicating cell membrane health and integrity, hydration, and nutritional status. Handgrip strength (HS) has been also associated with body composition, nutritional status, inflammation, and functional ability in several chronic diseases. Although their prognostic significance as independent biomarkers has been already investigated regarding the outcomes of a cardiac surgery, our study is the first one to assess the combined predictive value of preoperative PA and HS. DESIGN AND METHODS HS and PA measurements were performed preoperativelyin 195 patients undergoing cardiac surgery. The association ofthe combination of HS and PAwith all-cause mortality rates was the primary study outcome, while its association with the intensive care unit (ICU) length of stay (LOS) was the secondary one. RESULTS PA was positively correlated with HS (r = 0.446, p < 0.005) and negatively with EuroSCORE II (r = - 0.306 p < 0.005). The combination of PA < 5.15 and HS < 25.5 was associated with higher one-year all-cause mortality (OR = 9.28; 95% CI 2.50-34.45; p = 0.001) compared to patients with PA > 5.15 and HS > 25.5, respectively. Patients with combined lower values of PA and HS (PA < 5.15 and HS < 30.7) were at higher risk of prolonged ICU LOS (OR = 4.02; 95% CI 1.53-10.56; p = 0.005) compared to those with higher PA-HS (PA > 5.15-HS > 30.7). The combination of PA-HS was also significantly linked with EuroSCORE II. CONCLUSION The combination of low preoperative PA and HS values was significantly associated with higher risk of all-cause mortality at 12 months and prolonged ICU LOS; thereby it might serve as a clinically useful prognostic biomarker after cardiac surgery procedures.
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Affiliation(s)
- Mairi Panagidi
- Department of Cardiothoracic Surgery, AHEPA University Hospitalof Thessaloniki, Thessaloniki, Greece
| | - Αndreas S Papazoglou
- First Department of Cardiology, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios V Moysidis
- First Department of Cardiology, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Elpiniki Vlachopoulou
- Department of Nutritional Sciences, International Hellenic University, Thessaloniki, Greece
| | | | - Evangelia Kouidi
- Laboratory of Sports Medicine, Department of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonios Galanos
- Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Tagarakis
- Department of Cardiothoracic Surgery, AHEPA University Hospitalof Thessaloniki, Thessaloniki, Greece
| | - Kyriakos Anastasiadis
- Department of Cardiothoracic Surgery, AHEPA University Hospitalof Thessaloniki, Thessaloniki, Greece
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Provenzano M, Serra R, Michael A, Bolignano D, Coppolino G, Ielapi N, Serraino GF, Mastroroberto P, Locatelli F, De Nicola L, Andreucci M. Smoking habit as a risk amplifier in chronic kidney disease patients. Sci Rep 2021; 11:14778. [PMID: 34285279 PMCID: PMC8292329 DOI: 10.1038/s41598-021-94270-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023] Open
Abstract
Several studies showed the association between non-traditional risk factors [proteinuria and estimated Glomerular Filtration Rate (eGFR)] and cardiovascular (CV) and renal outcomes. Nevertheless, the etiologic role of traditional CV risk factors in referred CKD patients is less defined. Herein, we examined the association between smoking habit and CV events, mortality and CKD progression. We undertook an observational analysis of 1306 stage III–V CKD patients. Smoking habit was modeled as a categorical (never, current or former smokers) and continuous (number of cigarettes/day) variable. Mean eGFR was 35.8 ± 12.5 mL/min/1.73 m2. Never, current and former smokers were 61.1%, 10.8% and 28.1%. During a median follow-up of 2.87 years, current and former smokers were at significant risk for CV events (HRs of 1.93 [95% CI, 1.18–3.16] and 1.44 [95% CI, 1.01–2.05]) versus never smokers. Current smokers were at increased mortality risk (HR 2.13 [95% CI, 1.10–4.11]). Interactions were found between former smokers and proteinuria (p = 0.007) and diabetes (p = 0.041) for renal risk, and between current smokers and male gender (p = 0.044) and CKD stage V (p = 0.039) for renal and mortality risk. In referred CKD patients, smoking habit is independently associated with CV events and mortality. It acts as a risk “amplifier” for the association between other risk factors and renal outcomes.
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Affiliation(s)
- Michele Provenzano
- Renal Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Viale Europa - Campus "Salvatore Venuta", 88100, Catanzaro, Italy
| | - Raffaele Serra
- Interuniversity Center of Phlebolymphology (CIFL), "Magna Graecia" University of Catanzaro, Catanzaro, Italy.,Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Ashour Michael
- Renal Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Viale Europa - Campus "Salvatore Venuta", 88100, Catanzaro, Italy
| | - Davide Bolignano
- Renal Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Viale Europa - Campus "Salvatore Venuta", 88100, Catanzaro, Italy
| | - Giuseppe Coppolino
- Renal Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Viale Europa - Campus "Salvatore Venuta", 88100, Catanzaro, Italy
| | - Nicola Ielapi
- Department of Public Health and Infectious Disease, "Sapienza" University of Rome, Rome, Italy
| | | | - Pasquale Mastroroberto
- Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Francesco Locatelli
- Nephrology Department, Alessandro Manzoni Hospital, Past Director, Lecco, Italy
| | - Luca De Nicola
- Renal Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele Andreucci
- Renal Unit, Department of Health Sciences, "Magna Graecia" University of Catanzaro, Viale Europa - Campus "Salvatore Venuta", 88100, Catanzaro, Italy.
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