The Effect of Acute Kidney Injury and Discharge Creatinine Level on Mortality Following Cardiac Surgery
The Effect of Acute Kidney Injury and Discharge Creatinine Level on Mortality Following Cardiac Surgery
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DOI：
10.1097/ccm.0000000000000409
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发表时间：
2014-09-01
影响因子：
8.8
通讯作者：
Schwann, Thomas A.
中科院分区：
文献类型：
--
作者：
Engoren, Milo;Habib, Robert H.;Schwann, Thomas A.
目的：心脏手术后急性肾损伤与手术死亡率和晚期死亡率增加有关。目的是确定短期和长期死亡率是否随着术后急性肾损伤逆转的完全性或残留肾功能的数量而系统地改善。设计：回顾性、单中心研究。环境：三级保健医院。患者：1543例心脏手术患者根据肾脏疾病国际组结局标准分为急性肾损伤组。测量和主要结果：手术死亡率总体为3.1%，随着急性肾损伤的增加，手术死亡率逐渐恶化：无（0.8%），最低（1.6%），肾脏疾病国际组结局期1(4.3%),2（17%）和3（29%）。与手术结果相似，随着急性肾损伤数量的增加，晚期结果逐渐恶化。晚期死亡的风险与急性肾损伤量和出院时的剩余肾功能有关。结论：急性肾损伤与较高的手术死亡率和晚期死亡率相关。较少的残余肾功能与晚期死亡率增加有关。
Objectives: Acute kidney injury after cardiac surgery is associated with increased operative and late mortality. The objective was to determine if short and long term mortality are systematically improved with completeness of postoperative acute kidney injury reversal or with amount of residual renal function.Design: Retrospective, single center study.Setting: Tertiary care hospital.Patients: One thousand five hundred and forty-three cardiac surgery patients divided into acute kidney injury groups based on Kidney Disease International Group Outcome criteria.Measurements and Main Results: Operative mortality was 3.1% overall and was progressively worse with increasing acute kidney injury: none (0.8%), minimal (1.6%), Kidney Disease International Group Outcome stage 1 (4.3%), stage 2 (17%), and stage 3 (29%). Similar to the operative outcomes, late outcomes were progressively worse with rising amounts of acute kidney injury. The risk of late death was related to amount of acute kidney injury and remaining renal function at discharge.Conclusions: Acute kidney injury was associated with higher operative and late mortality. Lesser amounts of residual renal function were associated with increased late mortality.