Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection
Background: Few studies on the risk factors for postoperative continuous renal replacement therapy (CRRT) in a homogeneous population of patients with acute type A aortic dissection (AAAD). This retrospective analysis aimed to investigate the risk factors for CRRT and in-hospital mortality in the pa...
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| Format: | Article |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.749592/full |
| _version_ | 1818401885706518528 |
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| author | Xuelian Chen Jiaojiao Zhou Miao Fang Jia Yang Xin Wang Siwen Wang Linji Li Tao Zhu Ling Ji Lichuan Yang |
| author_facet | Xuelian Chen Jiaojiao Zhou Miao Fang Jia Yang Xin Wang Siwen Wang Linji Li Tao Zhu Ling Ji Lichuan Yang |
| author_sort | Xuelian Chen |
| collection | DOAJ |
| description | Background: Few studies on the risk factors for postoperative continuous renal replacement therapy (CRRT) in a homogeneous population of patients with acute type A aortic dissection (AAAD). This retrospective analysis aimed to investigate the risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery and to discuss the perioperative comorbidities and short-term outcomes.Methods: The study collected electronic medical records and laboratory data from 432 patients undergoing surgery for AAAD between March 2009 and June 2021. All the patients were divided into CRRT and non-CRRT groups; those in the CRRT group were divided into the survivor and non-survivor groups. The univariable and multivariable analyses were used to identify the independent risk factors for CRRT and in-hospital mortality.Results: The proportion of requiring CRRT and in-hospital mortality in the patients with CRRT was 14.6 and 46.0%, respectively. Baseline serum creatinine (SCr) [odds ratio (OR), 1.006], cystatin C (OR, 1.438), lung infection (OR, 2.292), second thoracotomy (OR, 5.185), diabetes mellitus (OR, 6.868), AKI stage 2–3 (OR, 22.901) were the independent risk factors for receiving CRRT. In-hospital mortality in the CRRT group (46%) was 4.6 times higher than in the non-CRRT group (10%). In the non-survivor (n = 29) and survivor (n = 34) groups, New York Heart Association (NYHA) class III-IV (OR, 10.272, P = 0.019), lactic acidosis (OR, 10.224, P = 0.019) were the independent risk factors for in-hospital mortality in patients receiving CRRT.Conclusion: There was a high rate of CRRT requirement and high in-hospital mortality after AAAD surgery. The risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery were determined to help identify the high-risk patients and make appropriate clinical decisions. Further randomized controlled studies are urgently needed to establish the risk factors for CRRT and in-hospital mortality. |
| first_indexed | 2024-12-14T07:59:35Z |
| format | Article |
| id | doaj.art-9aee0af017444daf836d6ac37b30ff98 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-14T07:59:35Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-9aee0af017444daf836d6ac37b30ff982022-12-21T23:10:27ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-11-01810.3389/fcvm.2021.749592749592Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic DissectionXuelian Chen0Jiaojiao Zhou1Miao Fang2Jia Yang3Xin Wang4Siwen Wang5Linji Li6Tao Zhu7Ling Ji8Lichuan Yang9Division of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, ChinaDivision of Ultrasound, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Orthopedics, Second People's Hospital of Chengdu, Chengdu, ChinaDivision of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, ChinaDepartment of Pediatric Nephrology, West China Second University Hospital, Sichuan University, Chengdu, ChinaDivision of Nephrology, Department of Medicine, West China Hospital of Sichuan University, Chengdu, ChinaDepartment of Anesthesiology, West China Hospital, Sichuan University, The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, ChinaDepartment of Anesthesiology, West China Hospital, Sichuan University, The Research Units of West China (2018RU012), Chinese Academy of Medical Sciences, Chengdu, ChinaDivision of Nephrology, West China Hospital of Sichuan University, Chengdu, ChinaDivision of Nephrology, West China Hospital of Sichuan University, Chengdu, ChinaBackground: Few studies on the risk factors for postoperative continuous renal replacement therapy (CRRT) in a homogeneous population of patients with acute type A aortic dissection (AAAD). This retrospective analysis aimed to investigate the risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery and to discuss the perioperative comorbidities and short-term outcomes.Methods: The study collected electronic medical records and laboratory data from 432 patients undergoing surgery for AAAD between March 2009 and June 2021. All the patients were divided into CRRT and non-CRRT groups; those in the CRRT group were divided into the survivor and non-survivor groups. The univariable and multivariable analyses were used to identify the independent risk factors for CRRT and in-hospital mortality.Results: The proportion of requiring CRRT and in-hospital mortality in the patients with CRRT was 14.6 and 46.0%, respectively. Baseline serum creatinine (SCr) [odds ratio (OR), 1.006], cystatin C (OR, 1.438), lung infection (OR, 2.292), second thoracotomy (OR, 5.185), diabetes mellitus (OR, 6.868), AKI stage 2–3 (OR, 22.901) were the independent risk factors for receiving CRRT. In-hospital mortality in the CRRT group (46%) was 4.6 times higher than in the non-CRRT group (10%). In the non-survivor (n = 29) and survivor (n = 34) groups, New York Heart Association (NYHA) class III-IV (OR, 10.272, P = 0.019), lactic acidosis (OR, 10.224, P = 0.019) were the independent risk factors for in-hospital mortality in patients receiving CRRT.Conclusion: There was a high rate of CRRT requirement and high in-hospital mortality after AAAD surgery. The risk factors for CRRT and in-hospital mortality in the patients undergoing AAAD surgery were determined to help identify the high-risk patients and make appropriate clinical decisions. Further randomized controlled studies are urgently needed to establish the risk factors for CRRT and in-hospital mortality.https://www.frontiersin.org/articles/10.3389/fcvm.2021.749592/fullacute type A aortic dissectionsurgeryacute kidney injurycontinuous renal replacement therapyCRRTrisk factors |
| spellingShingle | Xuelian Chen Jiaojiao Zhou Miao Fang Jia Yang Xin Wang Siwen Wang Linji Li Tao Zhu Ling Ji Lichuan Yang Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection Frontiers in Cardiovascular Medicine acute type A aortic dissection surgery acute kidney injury continuous renal replacement therapy CRRT risk factors |
| title | Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection |
| title_full | Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection |
| title_fullStr | Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection |
| title_full_unstemmed | Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection |
| title_short | Incidence- and In-hospital Mortality-Related Risk Factors of Acute Kidney Injury Requiring Continuous Renal Replacement Therapy in Patients Undergoing Surgery for Acute Type a Aortic Dissection |
| title_sort | incidence and in hospital mortality related risk factors of acute kidney injury requiring continuous renal replacement therapy in patients undergoing surgery for acute type a aortic dissection |
| topic | acute type A aortic dissection surgery acute kidney injury continuous renal replacement therapy CRRT risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.749592/full |
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