Cardio- and Cerebrovascular Outcomes of Postoperative Acute Kidney Injury in Noncardiac Surgical Patients With Hypertension.
Cardio- and Cerebrovascular Outcomes of Postoperative Acute Kidney Injury in Noncardiac Surgical Patients With Hypertension.
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非心脏外科高血压患者术后急性肾损伤的心脑血管结局
DOI：
10.3389/fphar.2021.696456
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发表时间：
2021
影响因子：
5.6
通讯作者：
Yao L
中科院分区：
文献类型：
--
作者：
Guangyu Y;Jingfeng L;Xing L;Hong Y;Yao L
Background: The cardiovascular and cerebrovascular risk of postoperative acute kidney injury (AKI) in surgical patients is poorly described, especially in the hypertensive population. Methods: We conducted a retrospective cohort study among all hypertensive patients who underwent elective noncardiac surgery from January 1st, 2012 to August 1st, 2017 at the Third Xiangya Hospital. The primary outcomes were fatal stroke and fatal myocardial infarction (MI). The secondary outcomes were all-cause mortality. Results: The postoperative cumulative mortality within 3 months, 6 months, 1 year, 2 years, and 5 years were 1.27, 1.48, 2.15, 2.15, and 5.36%, for fatal stroke, and 2.05, 2.27, 2.70, 3.37, and 5.61% for fatal MI, respectively, in patients with postoperative AKI. Compared with non-AKI patients, those with postoperative AKI had a significantly higher risk of fatal stroke and fatal MI within 3 months [hazard ratio (HR): 5.49 (95% CI: 1.88−16.00) and 11.82 (95% CI: 4.56−30.62), respectively], 6 months [HR: 3.58 (95% CI: 1.43−8.97) and 9.23 (95% CI: 3.89−21.90), respectively], 1 year [HR: 3.64 (95% CI: 1.63−8.10) and 5.14 (95% CI: 2.50−10.57), respectively], 2 years [HR: 2.21 (95% CI: 1.03−4.72) and 3.06 (95% CI: 1.66−5.64), respectively], and 5 years [HR: 2.27 (95% CI: 1.30−3.98) and 1.98 (95% CI: 1.16−3.20), respectively]. In subgroup analysis of perioperative blood pressure (BP) lowering administration, postoperative AKI was significantly associated with 1-year and 5-year risk of fatal stroke [HR: 9.46 (95% CI: 2.85−31.40) and 3.88 (95% CI: 1.67−9.01), respectively] in patients with ACEI/ARB, and MI [HR: 6.62 (95% CI: 2.23−19.62) and 2.44 (95% CI: 1.22−4.90), respectively] in patients with CCB. Conclusion: Hypertensive patients with postoperative AKI have a significantly higher risk of fatal stroke and fatal MI, as well as all-cause mortality, within 5 years after elective noncardiac surgery. In patients with perioperative administration of ACEI/ARB and CCB, postoperative AKI was significantly associated with higher risk of fatal stroke and MI, respectively.
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DOI：
10.1186/cc13158
发表时间：
2013-12-12
期刊：
Critical care (London, England)
影响因子：
--
作者：
Hansen MK;Gammelager H;Mikkelsen MM;Hjortdal VE;Layton JB;Johnsen SP;Christiansen CF
通讯作者：
Christiansen CF
影响因子：
2.3
作者：
Arias-Cabrales, Carlos;Rodriguez, Eva;Pascual, Julio
通讯作者：
Pascual, Julio
影响因子：
5.7
作者：
Beattie, W. Scott;Wijeysundera, Duminda N.;Tait, Gordon
通讯作者：
Tait, Gordon
影响因子：
2.5
作者：
Depret, Francois;Prud'homme, Mathilde;Legrand, Matthieu
通讯作者：
Legrand, Matthieu
影响因子：
2.5
作者：
Gameiro, Joana;Duarte, Ines;Lopes, Jose Antonio
通讯作者：
Lopes, Jose Antonio