非体外循环冠状动脉旁路移植术后肾损伤风险因素的分析

目的:探讨非体外循环冠状动脉移植术(OPCABG)术后急性肾损伤(AKI)的风险因素。方法:回顾性分析我院2012年6月至2013年5月,1 050例OPCABG手术患者的临床资料。根据术后肾功能状况,分为AKI组139例(13.2%)和对照组,比较两组围术期相关因素的差异,应用Logistic回归分析OPCABG术后AKI的风险因素。结果:高龄、代谢综合征、陈旧性心肌梗死、急诊手术、明显外周血管粥样狭窄、左心室低射血分数(35%~40%)患者的比例,AKI组明显高于对照组;术前C反应蛋白(CRP)、胱抑素C水平,AKI组明显高于对照组;冠状动脉造影与外科手术的时间间隔,AKI组明显短于于对照组;术前规律应用他汀药物患者比例,AKI组明显低于对照组;术中心血管活性药物(去甲肾上腺素和肾上腺素)用量、术中目标冠状动脉吻合总时间,AKI组明显高于对照组;术中因冠状动脉弥散狭窄无法完全再血管化、术中及术后主动脉内球囊反搏(IABP)、术后急性心肌梗死患者比例、平均呼吸机辅助时间,AKI组明显高于对照组;术后液体补给容量,AKI组明显低于对照组。Logistic多因素回归分析显示,高龄(OR=2.55;95%CI:1.34~4.45;P0.01)、代谢综合征(OR=2.35;95%CI:1.42~4.76;P0.01)、术前高CRP水平(OR=2.24;95%CI:1.31~4.46;P=0.01)、术前高胱抑素C水平(OR=2.54;95%CI:2.11~5.36;P0.01)、急诊手术(OR=3.23;95%CI:2.22~6.76;P0.01)、明显外周血管粥样狭窄(OR=1.67;95%CI:1.21~4.06;P=0.04)、左心室低射血分数(OR=4.12;95%CI:2.26~7.76;P0.01)、术前短时间冠状动脉造影(OR=1.75;95%CI:1.34~3.76;P=0.03)、术前未规律应用他汀药物(OR=1.81;95%CI:1.37~3.96;P=0.03)、无法完全再血管化(OR=3.05;95%CI:2.21~5.39;P0.01)、术后急性心肌梗死(OR=4.12;95%CI:3.54~8.09;P0.01)、术中及术后IABP辅助(OR=3.23;95%CI:2.34~6.19;P0.01)为术后肾损伤的风险因素。结论:术前对比剂等肾毒性物质加重肾脏负担,他汀类药物一定程度提供保护作用;高龄、术前较差的机体代谢状况、慢性肾功能受损,预示肾功能储备下降;术前应激状态、术中心肌供血改善不足、围术期低下的心肌收缩状态,加重了肾脏损害或导致肾脏损害难以恢复。     

冠状动脉旁路移植术患者并发急性肾损伤影响因素的Meta分析

背景冠状动脉旁路移植术(CABG)是临床治疗冠状动脉粥样硬化性心脏病的主要手术方式,急性肾损伤(AKI)是其常见的严重并发症之一。早期总结CABG患者并发AKI的危险因素对识别高危人群并制定干预措施具有重要意义,目前尚未见相关Meta分析及系统评价报道。目的采用Meta分析法探讨CABG患者并发AKI的影响因素,以期为预防CABG患者并发AKI提供循证依据。方法计算机检索PubMed、Embase、Cochrane Library及中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库,检索时限为建库至2021年6月。检索CABG患者并发AKI影响因素的相关文献。病例组为CABG后并发AKI患者,对照组为CABG后未并发AKI患者。收集患者一般因素、客观指标、疾病类型、手术因素进行Meta分析。采用漏斗图分析纳入相关指标的文献是否存在发表偏倚。结果最终纳入25篇文献,包含16 035例患者,其中对照组11 959例,病例组4 076例。Meta分析结果显示,两组患者年龄、体质指数(BMI)、血肌酐(Scr)水平、估算肾小球滤过率(eGFR)、欧洲心血管手术危险因素评分系统(Eu...     

冠状动脉旁路移植术后急性肾损伤患者的预后分析——基于多中心的中期随访研究

目的 分析冠状动脉旁路移植术(coronary artery bypass grafting,CABG)后急性肾损伤(acute kidney injury,AKI)患者的中期预后情况.方法 回顾性分析2013年01月至2020年06月在南京市第一医院,江苏省人民医院和上海市第一人民医院行CABG患者的完整住院资料.根...     

非体外循环冠状动脉旁路移植术后房颤相关因素分析

对312例非体外循环下冠状动脉旁路移植术(OPCAB)患者术后心房颤动(AF)的发生情况进行监测,将患者分为AF组和非AF组,对术前、术中和术后的相关因素进行分析,筛选出易致AF的有关因素.结果 OP-CAB术后AF的发生率为15.7%,高龄、高血压、急诊手术、血管桥数、术后早期没及时用β受体阻滞剂、血钾浓度是术后AF的危险因素.认为OPCAB术后AF的发生较普遍,围术期需进行风险评估,对高危患者进行干预,以减少术后AF的发生.     

非体外循环冠状动脉旁路移植术后远期死亡的危险因素分析

目的 分析非体外循环冠状动脉旁路移植术（OPCAB）后远期死亡的危险因素。 方法 选取阜外医院2009年10月到2012年9月期间由单一术者施行的单纯OPCAB治疗的595例患者,围手术期的临床资料从阜外医院数据库中提取,远期随访采用电话随访和门诊随访的方式进行。采用单因素和多因素Logistic回归分析与OPCAB远期死亡的相关因素。结果 全组患者平均随访时间8年,共有70例患者死亡,远期死亡发生率为11.8%。死亡组与存活组患者在年龄、术前肌酐、高血压、慢性阻塞性肺疾病（COPD）、术前血红蛋白、术前左心室射血分数（LVEF）、围术期输血、外周动脉疾病的差异具有统计学意义（P＜0.05）。多因素Logistic回归分析显示结果显示年龄（OR=1.069, 95%CI：1.031-1.108, p=0.000）、术前肌酐（OR=1.021, 95%CI：1.008-1.033, p=0.001）、高血压（OR=2.513, 95%CI：1.209-5.221, p=0.014）、COPD（OR=7.140, 95%CI：2.342-21.768, p=0.001）是OPCAB术后远期死亡的独立危险因素,LVEF（OR=0.948, 95%CI：0.920-0.977, p=0.001）是OPCAB术后远期死亡的保护因素,即术前LVEF值越高,远期死亡的风险越低。 结论 年龄、术前肌酐、高血压、COPD是OPCAB患者远期死亡的独立危险因素,LVEF是保护因素。     

312例非体外循环冠状动脉旁路移植术的危险因素评价

目的：分析与探讨312例非体外循环冠状动脉旁路移植术（OPCAB）危险因素评价的特点，方法：1999年10月－2001年6月连续312例OPCAB手术，死亡7例，通过回顾性分析临床资料，采用没形式的单因素分析法和多元逐步回归分析，筛选出死亡相关的危险因素。结果：急症手术，左心室射血分数，慢性肾功能不全，糖尿病和机械通气时间依次是本组OPCAB手术的死亡相关危险因素，其相对危险度分别是20．718，0．942，19．366，3．821，1．029，年龄，性别，二次手术，心肌梗死1周内属于常规冠状动脉旁路移植术（cCABG)的危险因素不构成OPCAB手术的危险因素，结论：OPCAB手术较cABG手术危险因素减少，体现出OPCAB手术良好的微创效果，但该结果尚有待于大规模多中心的综合评价验证。     

冠状动脉旁路移植术后心房颤动的高危因素分析

目的　研究冠状动脉旁路移植术 (CABG)后心房颤动 (AF)的发病特点 ,分析AF的高危因素。方法　采用回顾性研究的方法 ,观察我院CABG患者 2 35例 ,监测手术前后心电图、2 4h动态心电图、心肌酶谱、心脏收缩功能、左心房内径、体外循环及主动脉阻断时间、和电解质变化等。结果　 2 35例患者CABG术后 4 2例 (17 9% )发生AF ,81%的AF发生于术后 1～ 3d ,持续 (12 0± 9 14 )h ,95 2 %患者 2 4h内恢复窦性心律 ;高龄 (≥ 70岁 )、低钾血症 (≤ 3 5mmol/L)、低镁血症 (≤ 0 70mmol/L)、左心功能不良[射血分数 (EF)≤ 0 4 0和 /或缩短分数 (FS)≤ 0 2 4 ]、左心房内径≥ 35mm、右冠状动脉狭窄≥ 70 %的患者术后AF发生率明显高于其他患者 (P分别为 0 0 0 1、0 0 0 9、0 0 16、0 0 30、0 0 36和 0 0 4 4 ) ;应用胺碘酮患者AF发生率明显降低。结论　低镁血症、左心房增大、右冠状动脉病变是术后AF的相关因素 ;高龄、左心室功能不良、低钾血症是术后AF的独立高危因素 ;预防应用胺碘酮能明显降低术后心室率 ,有效地抑制术后AF的发生 ,促进AF转复 ,明显改善左心室功能 ,并且具有较好安全性和耐受性 ,是术后AF的保护因素     

伴卒中史患者非体外循环冠状动脉旁路移植术后再发急性脑梗死的影响因素分析

目的探讨伴有卒中史患者非体外循环冠状动脉旁路移植(OPCAB)术后再发急性脑梗死的相关因素。方法回顾性分析首都医科大学附属北京安贞医院2010年1月—2012年9月,468例有卒中史OPCAB手术患者的临床资料。根据术后有无再发急性脑梗死分为再发脑梗死组(A组)41例和无再发脑梗死组(B组)427例。分析与缺血事件发生的相关因素[术后再发脑梗死的时间为完成手术入住重症监护病房(ICU)期间]。结果 468例OPCAB手术患者术后再发急性脑梗死41例,占8.8%。①单因素分析显示,A、B组间术前双侧颈内动脉重度狭窄[(41.5%(17/41),8.9%(38/427)]、术前左心室射血分数≤35%[53.7%(22/41),25.8%(110/427)]、术中En-closeⅡ主动脉近端吻合器的应用[19.5%(8/41),76.3%(326/427)]、术后急性心肌梗死[34.1%(14/41),9.1%(39/427)]、术后心房颤动[48.8%(20/41),10.8%(46/427)]、术后低血压[68.3%(28/41),18.7%(80/427)]、术后机械通气时间>72 h[(75.6%(31/41),15.0%(64/427)]、入住ICU时间>72 h[(82.9%(34/41),25.3%(108/427)]及病死率[(29.3%(12/41),5.4%(23/427)],差异均有统计学意义(均P<0.01)。②多因素Logistic回归分析显示,术前双侧颈内动脉重度狭窄(OR=6.338,95%CI:2.283～21.019)、术前左心室射血分数≤35%(OR=2.737,95%CI:1.267～6.389)、术后急性心肌梗死(OR=3.656,95%CI:1.933～6.894)、术后心房颤动(OR=3.104,95%CI:1.135～8.016)与术后低血压(OR=4.173,95%CI:1.836～9.701)是OPCAB患者术后再发急性脑梗死的独立危险因素。术中应用EncloseⅡ主动脉近端吻合器(OR=0.556,95%CI:0.337～0.925)是OPCAB患者术后再发急性脑梗死的保护因素。结论伴有卒中史患者行OPCAB术后,再发急性脑梗死的发生率及病死率高,术前双侧颈内动脉重度狭窄、术前左心室射血分数≤35%、术后急性心肌梗死、术后心房颤动和术后低血压是伴有卒中史患者OPCAB术后再发急性脑梗死的独立危险因素。而术中应用EncloseⅡ主动脉近端吻合器是伴有卒中史患者OPCAB术后再发急性脑梗死的保护因素。     

体外循环下冠状动脉旁路移植术后急性肾损伤发生与早期临床结果

目的明确体外循环下冠状动脉旁路移植术(on-pump coronary artery bypass surgery,ONCABG)患者术后心脏手术相关急性肾损伤(acute kidney injury associated with cardiac surgery,CSA-AKI)发生的危险因素及肾损伤对患者早期临床结果的影响。方法回顾性分析阜外医院2011年9月至2013年11月接受体外循环下单纯ONCABG的779例患者的临床资料。根据2012年KDIGO肾损伤诊断标准明确患者术后肾损伤情况并分为CSA-AKI组与无CSA-AKI组。应用Logistic二元回归分析方法,明确ONCABG患者术后CSA-AKI的发生相关的危险因素并评估CSA-AKI发生对ONCABG患者早期临床结果的影响。结果患者平均年龄为(59.8±8.5)岁,女性占18.9%,术中平均体外循环时间为(102.1±33.8)min。术后总的CSA-AKI发生率为74.1%。CSA-AKI组患者术后感染发生率(12.8%vs 7.4%,P=0.038)、呼吸机通气时间(22.8 mins vs 17.2 mins,P=0.003)、ICU停留时间(63.0 vs 44.5h,P<0.001)、术后住院天数(8.8 d vs 8.0 d,P=0.011)均显著高于无CSA-AKI组。CSA-AKI组与无CSA-AKI组术中应用体外循环时间(103.3 min vs 98.8 min,P=0.101)无统计学差异。Logistic回归分析显示:年龄是ONCABG患者术后CSA-AKI的独立影响因素(OR:1.02,95%CI:1.00~1.04,P=0.040),患者年龄越大愈加容易发生术后CSA-AKI。同时术前最后一次肌酐水平越低患者容易达到急性肾损伤的诊断标准。结论ONCABG患者术后心脏手术相关急性肾损伤的发生显著影响患者早期预后,高龄是ONCABG患者术后发生心脏手术相关急性肾损伤的独立危险因素。术前肌酐水平较低患者更容易达到急性肾损伤的诊断标准。     

影响老龄冠状动脉旁路移植术后新发心房颤动的危险因素

目的:目前尚缺乏针对老龄患者冠状动脉旁路移植术(Coroanry artery bypass grafting,CABG)后新发心房颤动(房颤)的风险因素分析.本研究以老龄CABG患者为研究对象,考察了影响老龄CABG后新发房颤的独立危险因素.方法:1999年至2005年间,有1 756例老龄患者(大于65岁)在我院接...     

行冠状动脉旁路移植术患者并中重度肾损伤的临床特征分析

目的 分析在行体外循环冠状动脉旁路移植术（coronary artery bypass grafting,CABG）的患者中,术前合并中重度肾损伤者的临床特征及住院预后。方法 回顾性分析2013年1月至2018年12月在南京市第一医院单纯行CABG患者的病史资料,通过肾脏疾病饮食改良（modification of diet in renal disease,MDRD）简化公式计算肾小球滤过率（estimated glomerular filtration rate,eGFR）,以60 ml·min-1·1.73m-2为界,将所有患者分为肾功能正常-轻度肾损伤组（eGFR≥60 ml·min-1·1.73m-2）和中-重度肾损伤组（eGFR<60 ml·min-1·1.73m-2）,比较两组患者的入院基本资料、术前合并症、临床检查及化验、手术及住院预后情况,采用1∶1倾向性评分分析（propensity score matching,PSM）平衡两组间基线资料的差异。结果 研究共纳入1466例患者,其中肾功能正常-轻度肾损伤组1333例,中-重度肾损伤组133例,9.1%的患者在术前合并中重度肾损伤。相比肾功能正常-轻度肾损伤组,中-重度肾损伤组患者年龄更大（62.8岁比69.0岁,P<0.001）,心功能更差（纽约心功能Ⅲ~Ⅳ级 55.1%比70.7%,P=0.001）,所患糖尿病（32.1%比42.9%,P=0.012）、高血压（63.6%比79.7%,P<0.001）、周围血管疾病（0.2%比4.5%,P<0.001）的比例更多,左心室射血分数更低（62.0%比62.0%,P=0.045）,术中需IABP辅助比例（2.1%比5.3%,P=0.023）更多,两组患者的其他临床资料差异无统计学意义（P均>0.05）。PSM对两组患者进行1∶1匹配,匹配成功248例,每组各124例。在住院预后方面,中重度肾损伤组患者的重症监护室（intensive care unit,ICU）监护时间（38.0 小时比43.5 小时,P=0.011）和住院时间（16.0 天比21.0 天,P<0.001）均更长,术后需要红细胞输注的比例（43.5%比58.9%,P=0.016）更多。散点图相关性分析提示,ICU监护时间和住院时间与患者术前eGFR水平呈线性负相关。两组病死率及其他并发症发生情况差异无统计学意义（P均>0.05）。结论 中重度肾损伤并不增加CABG术后住院病死率,但是延长ICU监护和住院时间,此类患者在术前即出现明显的病理生理改变,中远期预后值得进一步评估。     

Risk score for predicting abdominal complications after coronary artery bypass grafting

BACKGROUND Although early abdominal complications after coronary artery bypass grafting(CABG) with cardiopulmonary bypass(CPB) are rare, the associated mortality remains high.AIM To develop a risk score for the prediction of early abdominal complications after CABG with CPB.METHODS This retrospective study was performed in the Federal State Budgetary Establishment Federal Center of Cardiovascular Surgery of the Ministry of Health of Russia(the city of Chelyabinsk) and included data of 6586 patients who underwent CABG with CPB during 2011-2017. The risk factors taken for evaluation were compared between patients with early abdominal complications(n = 73) and without them(n = 6513). We identified the most important risk factors and their influence on the development of early abdominal complications after CABG with CPB.RESULTS Gender and the presence of postinfarction cardiosclerosis, chronic kidney disease, or diabetes in the anamnesis did not affect the occurrence of abdominal complications. The leading risk factors of the early abdominal complications after CABG with CPB were multifocal atherosclerosis, extracorporeal membrane oxygenation, intra-aortic balloon pump, atrial fibrillation, perioperative myocardial infarction, and the need for resternotomy in the postoperative period. The average value of the predicted probability was 0.087 ± 0.015 in patients with early abdominal complications after CABG with CPB and 0.0094 ± 0.0003 in patients without these complications. The percentage of correct classification turned out to be 98.9%. After calculating a score for each of the leading risk factors, we counted a total score for each particular patient. The highest risk was noted in patients with a total score of 7 or more.CONCLUSION The developed score predicts the risk of early abdominal complications after CABG with CPB and makes it possible to stratify patients by risk groups.     

Acute kidney injury after coronary artery bypass grafting and long-term risk of myocardial infarction and death

Background

Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with early mortality. Its impact on the risk of myocardial infarction (MI) over time and long-term mortality has not been well described.

Methods

We performed a nationwide population-based cohort study in 27,929 patients who underwent a first isolated CABG between 2000 and 2008 in Sweden. Acute kidney injury was divided into three categories based on the absolute increase in postoperative serum creatinine (sCr) concentration compared with the preoperative baseline: stage 1, sCr increase of 0.3 to 0.5 mg/dL; stage 2, sCr increase of > 0.5 to 1.0 mg/dL and stage 3, sCr increase of ≥ 1.0 mg/dL.

Results

The overall incidence of postoperative AKI was 13%, 6.3% met the criterion for stage 1, 4.3% for stage 2 and 2.3% for stage 3. During a mean follow-up of 5.0 years, there were 2119 (7.6%) MIs and 4679 (17%) deaths.Multivariable adjusted hazard ratios with 95% confidence intervals for MI were 1.35 (1.15 to 1.57), 1.80 (1.53 to 2.13) and 1.63 (1.29 to 2.07), in AKI stages 1, 2 and 3, respectively. The corresponding hazard ratios for all-cause mortality were 1.30 (1.17 to 1.44), 1.65 (1.48 to 1.83) and 2.68 (2.37 to 3.03), respectively.

Conclusions

Our results show that AKI after CABG is associated with an increased long-term risk of MI and death.     

冠状动脉旁路移植术后低氧血症的分析和防治

目的探讨冠状动脉旁路移植术后低氧血症发生的危险因素和防治措施。方法回顾性分析冠状动脉旁路移植术后患者低氧血症的发生与年龄、术前肺功能、左室射血分数（LVEF）、体外循环时间、肺部感染的关系及低氧血症发生后的处理效果和死亡率。结果64例冠状动脉旁路移植术患者,术后发生低氧血症17例,发生率为26．6％。低氧血症组与正常组在年龄、FEV1．0％、LVEF、体外循环时间、肺部感染率等相关危险因素方面比较差异有统计学意义（P〈0．05）。结论积极防治低氧血症是降低冠状动脉旁路移植术死亡率的重要措施。     

Acute kidney injury and long-term risk of stroke after coronary artery bypass surgery

Background

Acute kidney injury (AKI) is associated with death, end-stage renal disease, and heart failure in patients with coronary heart disease. This study investigated the association between AKI and long-term risk of stroke.

Methods and results

50,244 patients who underwent coronary artery bypass grafting (CABG) in Sweden between 2000 and 2008 were identified from the SWEDEHEART registry. After exclusions 23,584 patients without prior stroke who underwent elective, primary, isolated, CABG were included. AKI was categorized according to absolute increases in postoperative creatinine values compared with preoperative values: stage 1, 0.3–0.5 mg/dL (26–44 μmol/L); stage 2, 0.5–1.0 mg/dL (44–88 μmol/L); and stage 3, > 1.0 mg/dL (≥ 88 μmol/L). Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for stroke. There were 1156 (4.9%) strokes during a mean follow-up of 4.1 years. After adjustment for confounders, HRs (95% CIs) for stroke in AKI stages 1, 2 and 3 were 1.12 (0.89–1.39), 1.31 (1.04–1.66) and 1.31 (0.92–1.87), respectively, compared with no AKI. This association disappeared after taking death into account in competing risk analysis. There was a significant association between AKI and stroke in men (HR: 1.26 [1.05–1.50]) but not in women (HR: 1.07 [0.75–1.53]), and in younger (< 65 years; HR: 1.57 [1.12–2.22]), but not elderly patients (HR: 1.17 [0.98–1.40]).

Conclusions

The long-term risk of stroke is weakly associated with AKI after primary isolated CABG, but this association is attenuated and not significant when considering death as a competing risk.     

体外循环与非体外循环下冠状动脉旁路移植术后肾损害

目的 探讨体外循环下冠状动脉旁路移植术(CCAB)与非体外循环下冠状动脉旁路移植术(OPCAB)后1周内肾损害及其变化规律.方法 我们对自1990年1月至2006年8月间849例单纯行冠状动脉旁路移植术的病例进行回顾性分析.采用logistic回归模型分析急性肾损害的风险因素.血清肌酐(Scr)130～199μmol/L或矫正的肌酐清除率30～60 ml·min-1.73 m-2作为急性肾损害(AKI)的诊断标准.结果 518例OPCAB发生AKI 61例,331例CCAB发生AKI 63例.AKI的风险因素包括:左心室射血分数(LVEF)>50%、LVEF<30%、脉压≥60 mm Hg(1 mm Hg=0.133 kPa)、外周血管疾病、糖尿病、急诊手术、3支病变、体质指数、术中及术后使用主动脉球囊反搏(IABP)、心功能分级、体外循环.其中INEF>50%、术中及术后使用IABP可能足保护因素(OR<1).术后发生肾损害患者的Scr峰值OPCAB组为术后12 h,CCAB组为术后24 h;Set快速恢复期OPCAB组为术后24～48 h,CCAB组为术后48～72 h.结论 AKI预防及治疗的天键期为自麻醉至OPCAB后48 h或CCAB后72 h.     

冠状动脉旁路移植术后呼吸机依赖的危险因素

目的:探讨冠状动脉旁路移植术(CABG)后发生呼吸机依赖(VD)的危险因素。方法:选取2007年1月至2007年8月行CABG的140例患者的临床资料进行回顾性分析。结果:本组140例中,发生VD17例(12.14%),年龄≥70岁、合并高血压、心功能Ⅲ级以上、肺动脉高压、术后低心排出量综合征及低白蛋白血症与呼吸机依赖发生关系密切。VD者比非VD者在ICU停留的时间明显延长(P<0.05),病死率明显增加(P<0.01)。结论:VD是CABG术后严重的并发症,可增加ICU停留时间及病死率。加强70岁以上患者的呼吸道管理,合理控制体循环血压及肺动脉压力,积极维护心功能,预防术后低心排出量综合征及低白蛋白血症等,是降低CABG术后发生VD的有效措施。     

Risk factors for acute kidney injury following coronary artery bypass graft surgery in a Chinese population and development of a prediction model

BACKGROUNDAcute kidney injury (AKI) after coronary artery bypass graft (CABG) surgery is associated with significant morbidity and mortality. This retrospective study aimed to establish a risk score for postoperative AKI in a Chinese population.METHODSA total of 1138 patients undergoing CABG were collected from September 2018 to May 2020 and divided into a derivation and validation cohort. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was used to determine the independent predictors of AKI, and the predictive ability of the model was determined using a receiver operating characteristic (ROC) curve.RESULTSThe incidence of cardiac surgery–associated acute kidney injury (CSA-AKI) was 24.17%, and 0.53% of AKI patients required dialysis (AKI-D). Among the derivation cohort, multivariable logistic regression showed that age ≥ 70 years, body mass index (BMI) ≥ 25 kg/m², estimated glomerular filtration rate (eGFR) ≤ 60 mL/min per 1.73 m², ejection fraction (EF) ≤ 45%, use of statins, red blood cell transfusion, use of adrenaline, intra-aortic balloon pump (IABP) implantation, postoperative low cardiac output syndrome (LCOS) and reoperation for bleeding were independent predictors. The predictive model was scored from 0 to 32 points with three risk categories. The AKI frequencies were as follows: 0−8 points (15.9%), 9−17points (36.5%) and ≥ 18 points (90.4%). The area under of the ROC curve was 0.730 (95% CI: 0.691−0.768) in the derivation cohort. The predictive index had good discrimination in the validation cohort, with an area under the curve of 0.735 (95% CI: 0.655−0.815). The model was well calibrated according to the Hosmer-Lemeshow test (P = 0.372). CONCLUSIONThe performance of the prediction model was valid and accurate in predicting KDIGO-AKI after CABG surgery in Chinese patients, and could improve the early prognosis and clinical interventions.