ACUTE-RENAL-FAILURE AFTER CORONARY SURGERY - A STUDY OF INCIDENCE AND RISK-FACTORS IN 2009 CONSECUTIVE PATIENTS
ACUTE-RENAL-FAILURE AFTER CORONARY SURGERY - A STUDY OF INCIDENCE AND RISK-FACTORS IN 2009 CONSECUTIVE PATIENTS
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DOI：
10.1055/s-2007-1013861
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发表时间：
1993-08-01
影响因子：
1.5
通讯作者：
WESSLEN, O
中科院分区：
文献类型：
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作者：
ANDERSSON, LG;EKROTH, R;WESSLEN, O
为了获得预测冠状动脉手术后急性肾功能衰竭（ARF）的模型，对2009例连续患者进行了研究。ARF定义为术后血清肌酸酐峰值超过术前值50%或以上或需要透析。术后血清肌酐升高小于50%与早期死亡率（术后小于或等于30天）相关。0.4%。16%的患者血清肌酐升高超过50%，该组死亡率为1.3%。 25例患者（1.2%）因ARF需要术后血液透析，其中11例（44%）早期死亡，而另外7例慢性肾衰竭患者（需要术前和术后血液透析）均存活。分析术后血清肌酐峰值和术前值的变化，并与临床变量相关。多因素分析显示，术前血肌酐升高、高龄、术后血流动力学不稳定是发生肾功能衰竭的重要危险因素。一个逻辑模型，包括这些危险因素与发展ARF的概率。
To obtain a model for the prediction of acute renal failure (ARF) after coronary surgery, 2009 consecutive patients were investigated. ARF was defined as a peak postoperative serum creatinine value exceeding the preoperative value by 50 % or more or a need for dialysis. A postoperative increase in serum creatinine of less than 50 % was associated with an early mortality (less-than-or-equal-to 30 days postop.) of 0.4 %. Sixteen per cent of the patients increased their serum creatinine by more than 50 % and in this group there was a mortality of 1.3 %. Twenty-five patients (1.2 %) required postoperative haemodialysis because of ARF and of these 11 (44 %) died early, whereas another 7 patients with chronic renal failure, requiring both pre- and postoperative haemodialysis, all survived. Peak postoperative serum creatinine and changes from the preoperative value were analyzed and related to clinical variables. Multivariate analysis indicated that high preoperative serum creatinine, high age and postoperative haemodynamic instability were the most important risk factors for developing renal failure. A logistic model including these risk factors versus the probability of developing ARF is presented.