Renal injury is associated with operative mortality after cardiac surgery for women and men.
Renal injury is associated with operative mortality after cardiac surgery for women and men.
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DOI：
10.1016/j.jtcvs.2010.02.021
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发表时间：
2010-12
影响因子：
6
通讯作者：
Hogue, Charles W.
中科院分区：
文献类型：
--
作者：
Mitter, Nanhi;Shah, Ashish;Yuh, David;Dodd-O, Jeffery;Thompson, Richard E.;Cameron, Duke;Hogue, Charles W.
本研究的目的是确定心脏手术后女性发生急性肾损伤的频率是否高于男性，以及这种并发症是否与女性的手术死亡率相关。从9461例术前未接受透析的冠状动脉旁路移植术和/或心脏瓣膜手术患者（3080例女性）中评价了Prosthesis收集的数据。使用术前末次血浆肌酐（基线）和术后第一周的最高水平，通过肾脏疾病饮食改良方程估计肾小球滤过率（eGFR）。原发性肾损伤结局是根据步枪标准（eGFR较基线降低> 50%）的肾损伤或肾衰竭的复合终点。30天手术死亡率和肾损伤女性高于男性（分别为5.9%和2.8%，P=0.01; 5.1%和3.6%，P<0.001）。尽管如此，当基线eGFR纳入多变量模型时，患者性别与肾损伤风险无关。肾损伤患者的围手术期并发症、ICU住院时间和死亡率均高于无肾损伤患者（女性，20.6% vs 3.2%，P<0.0001;男性，18.3% vs 2.2%，P<0.001）。肾损伤与女性（OR，3.96; 95%CI，1.86-8.44，P<0.0001）和男性（OR，4.05; 95%CI，2.19-7.48，P<0.0001）的30天死亡率独立相关。术后肾损伤与30天死亡率独立相关，与患者性别无关。与男性相比，女性肾损伤的发生率更高，部分原因可能是手术前低eGFR的患病率更高。心脏手术后肾损伤在女性中比男性更常见。无论患者性别如何，这种并发症的发生与30天死亡率升高独立相关。
The purpose of this study was to determine whether acute renal injury develops more frequently in women than in men after cardiac surgery and whether this complication is associated with operative mortality in women. Prospectively collected data were evaluated from 9461 coronary artery bypass graft and/or cardiac valve surgery patients (3080 women) not on preoperative dialysis. Glomerular filtration rate (eGFR) was estimated by the Modification of Diet in Renal Disease equations using the last plasma creatinine before surgery (baseline) and the highest level of the first postoperative week. The primary renal injury outcome was the composite endpoint of renal injury according to RIFLE criteria (eGFR decrease > 50% from baseline) or failure. Thirty-day operative mortality and renal injury were more common in women than in men (5.9% vs 2.8%, P=0.01; 5.1% vs 3.6%, P<0.001, respectively). Nonetheless, patient sex was not independently associated with risk for renal injury when baseline eGFR was included in multivariate modeling. Perioperative complications, ICU length of stay, and mortality were more frequent for patients with than without renal injury (women, 20.6% vs 3.2%, P<0.0001; men, 18.3% vs 2.2%, P<0.001). Renal injury was independently associated with 30-day mortality for women (OR, 3.96; 95% CI, 1.86–8.44, P<0.0001) and men (OR, 4.05; 95% CI, 2.19–7.48, P<0.0001). Postoperative renal injury is independently associated with 30-day mortality regardless of patient sex. Higher rates of renal injury in women compared with men might be explained in part by a higher prevalence of low eGFR before surgery. Renal injury is more common in women than in men after cardiac surgery. Regardless of patient sex, the development of this complication is independently associated with elevated 30-day mortality.
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影响因子：
39.2
作者：
Mangano, CM;Diamondstone, LS;Mangano, DT
通讯作者：
Mangano, DT
影响因子：
39.3
作者：
Liakopoulos, Oliver J.;Choi, Yeong-Hoon;Wahlers, Thorsten
通讯作者：
Wahlers, Thorsten
影响因子：
5.9
作者：
Chertow, GM;Levy, EM;Daley, J
通讯作者：
Daley, J
影响因子：
8.8
作者：
Hogue, CW;Sundt, T;Dávila-Román, VG
通讯作者：
Dávila-Román, VG
DOI：
10.1016/s0022-5223(99)70475-7
发表时间：
1999-01-01
影响因子：
6
作者：
Dávila-Román, VG;Kouchoukos, NT;Barzilai, B
通讯作者：
Barzilai, B