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Ma X, Li J, Yun Y, Zhao D, Chen S, Ma H, Wang Z, Zhang H, Zou C, Cui Y. Risk factors analysis of acute kidney injury following open thoracic aortic surgery in the patients with or without acute aortic syndrome: a retrospective study. J Cardiothorac Surg 2020; 15:213. [PMID: 32767994 PMCID: PMC7412815 DOI: 10.1186/s13019-020-01257-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background The acute kidney injury (AKI) remains a frequent complication following open thoracic aortic surgery (OTAS) and worsens the postoperative prognosis. It remains unclear that whether the predictors of AKI following OTAS are different in the patients with or without acute aortic syndrome (AAS). Methods Preoperative and intraoperative variables were compared between the patients with or without AKI, and were further analyzed for identifying the potential predictors of postoperative AKI. Subgroup analysis was conducted in the patients with or without AAS, respectively. Results AKI after OTAS occurred in 57.6% of the overall cohort, 70.1% of the patients with AAS and 46.7% of the patients without AAS. In the multivariate analysis, history of hypertension (OR 1.011, 95% CI: [1.001–1.022], p = 0.04), preoperative platelet (OR 0.995, 95% CI: [0.991–0.999], p = 0.006) and operation time (OR 1.572, 95% CI: [1.355–1.823], p < 0.001) were identified as independent predictors of postoperative AKI for the overall cohort; CPB time (OR 1.020, 95% CI: [1.009–1.031], p < 0.001) and preoperative LMR (OR 0.823, 95% CI: [0.701–0.966], p = 0.02) as independent predictors for the patients with AAS; age (OR 1.045, 95% CI: [1.015–1.076], p = 0.003), preoperative platelet (OR 0.993, 95% CI: [0.988–0.998], p = 0.04) and operation time (OR 1.496, 95% CI: [1.166–1.918], p = 0.002) as independent predictors for the patients without AAS. Conclusions The patients with AAS carry a higher risk for postoperative AKI compared with those without AAS. The predictive factors for postoperative AKI after OTAS are different for AAS- and non-AAS subgroups and operation time, CPB time and preoperative platelet are modifiable predictors of AKI.
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Affiliation(s)
- Xiaochun Ma
- Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China. .,Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.
| | - Jinzhang Li
- College of Basic Medicine, Capital Medical University, Beijing, China
| | - Yan Yun
- Department of Radiology, Qilu Hospital of Shandong University, No.107 West Wenhua Road, Jinan, 250012, Shandong, China
| | - Diming Zhao
- Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.,Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Shanghao Chen
- Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.,Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Huibo Ma
- Qingdao University Medical College, Qingdao University, 308 Ningxia Road, Qingdao, 266071, Shandong, China
| | - Zhengjun Wang
- Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.,Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Haizhou Zhang
- Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.,Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Chengwei Zou
- Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China.,Department of Cardiovascular Surgery, Shandong Provincial Hospital affiliated to Shandong University, No.324 Jingwu Road, Jinan, 250021, Shandong, China
| | - Yuqi Cui
- Department of Cardiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No.324 Jingwu Road, Jinan, 250021, Shandong, China. .,Center for Precision Medicine and Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, 65212, USA.
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