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find Author "WANG Xudong" 1 results
  • Application of Acute Kidney Injury Criteria and Classification to Predict Mortality Following Cardiovascular Surgery

    Abstract: Objective To evaluate the incidence and prognosis of postoperative acute kidney injury (AKI) in patients after cardiovascular surgery, and analyse the value of AKI criteria and classification using the Acute Kidney Injury Network (AKIN) definition to predict their in-hospital mortality. Methods A total of 1 056 adult patients undergoing cardiovascular surgery in Renji Hospital of School of Medicine, Shanghai Jiaotong University from Jan. 2004 to Jun. 2007 were included in this study. AKI criteria and classification under AKIN definition were used to evaluate the incidence and in-hospital mortality of AKI patients. Univariate and multivariate analyses were used to evaluate preoperative, intraoperative, and postoperative risk factors related to AKI. Results Among the 1 056 patients, 328 patients(31.06%) had AKI. In-hospital mortality of AKI patients was significantly higher than that of non-AKI patients (11.59% vs. 0.69%, P<0.05). Multivariate logistic regression analysis suggested that advanced age (OR=1.40 per decade), preoperative hyperuricemia(OR=1.97), preoperative left ventricular failure (OR=2.53), combined CABG and valvular surgery (OR=2.79), prolonged operation time (OR=1.43 per hour), postoperative hypovolemia (OR=11.08) were independent risk factors of AKI after cardiovascular surgery. The area under the ROC curve of AKIN classification to predict in-hospital mortality was 0.865 (95% CI 0.801-0.929). Conclusion Higher AKIN classification is related to higher in-hospital mortality after cardiovascular surgery. Advanced age, preoperative hyperuricemia, preoperative left ventricular failure, combined CABG and valvular surgery, prolonged operation time, postoperative hypovolemia are independent risk factors of AKI after cardiovascular surgery. AKIN classification can effectively predict in-hospital mortality in patients after cardiovascular surgery, which provides evidence to take effective preventive and interventive measures for high-risk patients as early as possible.

    Release date:2016-08-30 05:51 Export PDF Favorites Scan
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