Risk factors and long-term outcomes of elderly patients complicating with acute kidney injury after type A acute aortic dissection surgery: a retrospective study.
Risk factors and long-term outcomes of elderly patients complicating with acute kidney injury after type A acute aortic dissection surgery: a retrospective study.
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老年患者A型急性主动脉夹层术后并发急性肾损伤的危险因素及长期结局：一项回顾性研究
DOI：
10.21037/jtd-20-2018
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发表时间：
2020-10
影响因子：
2.5
通讯作者：
Wang D
中科院分区：
文献类型：
--
作者：
Wang Z;Ge M;Chen T;Chen C;Zong Q;Lu L;Li K;Wang D
在接受A型急性主动脉夹层（TA-AAD）急诊手术的老年患者中确定急性肾损伤（阿基）的风险因素和长期结局。本回顾性研究入组了2014年1月至2018年12月在南京鼓楼医院接受TA-AAD急诊手术的214例连续患者。阿基的诊断基于肾脏疾病：改善全球结局定义（KDIGO）标准。进行多变量回归分析，以确定术后阿基的风险因素。生成Kaplan-Meier曲线以比较TA-AAD手术后有和无阿基并发症的患者之间的长期结局。在所有入组患者中，114例（53.3%）在术后期间发生阿基。有或无阿基患者的中位年龄分别为68.0（64.0，74.0）和66.0（62.0，72.8）岁。43例患者（20.1%）需要肾脏替代治疗（RRT）。所有入组患者的30天死亡率为21.5%，其中阿基组为26.3%，非AKI组为16.0%（P=0.067）。多变量logistic回归分析显示，较长的机械通气时间是发生阿基的唯一独立危险因素。此外，我们的数据表明，长期累积生存率在两组之间是不同的。TA-AAD手术后的术后阿基很常见，与老年患者的长期死亡率恶化相关。较长的术后机械通气时间被确定为发生阿基的唯一独立风险因素。
To identify risk factors and long-term outcomes for acute kidney injury (AKI) in elderly patients who underwent type A acute aortic dissection (TA-AAD) emergency surgeries. This retrospective study enrolled 214 consecutive patients who underwent TA-AAD emergency surgeries between January 2014 to December 2018 in Nanjing Drum Tower hospital. The diagnosis of AKI was made based on the Kidney Disease: Improving Global Outcomes definition (KDIGO) criteria. Multivariable regression analysis was performed to identify risk factors for postoperative AKI. Kaplan-Meier curves were generated to compare the long-term outcomes between patients with and without AKI complication after TA-AAD surgeries. Among all enrolled patients, 114 (53.3%) developed AKI during postoperative period. The median age of patients with or without AKI was 68.0 (64.0, 74.0) and 66.0 (62.0, 72.8) years respectively. Renal replacement therapy (RRT) was required in 43 patients (20.1%). The 30-day mortality rate was 21.5% in all enrolled patients with 26.3% in AKI group and 16.0% in non-AKI group (P=0.067) respectively. Longer mechanical ventilation duration was identified as the only independent risk factor for developing AKI by multivariable logistic regression analysis. In addition, our data suggested that the long-term cumulative survival rate was different between two groups. Postoperative AKI after TA-AAD surgeries was common and associated with worsened long-term mortality in elderly patients. Longer postoperative mechanical ventilation duration was identified as the only independent risk factor for the development of AKI.
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影响因子：
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作者：
Amano, Kentaro;Takami, Yoshiyuki;Takagi, Yasushi
通讯作者：
Takagi, Yasushi
影响因子：
4.6
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影响因子：
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Sun, Li-Zhong
影响因子：
5.5
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影响因子：
3.3
作者：
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通讯作者：
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