Stage 1 acute kidney injury is independently associated with infection following cardiac surgery |
| |
Authors: | Benjamin R. Griffin J. Pedro Teixeira Sophia Ambruso Michael Bronsert Jay D. Pal Joseph C. Cleveland T. Brett Reece David A. Fullerton Sarah Faubel Muhammad Aftab |
| |
Affiliation: | 2. Department of Internal Medicine, Division of Nephrology and Hypertension, University of Utah, School of Medicine, Salt Lake City, UT;3. Department of Anesthesiology, University of Utah, School of Medicine, Salt Lake City, UT;4. Department of Statistics, Brigham Young University, Provo, UT;5. Department of Surgery, Division of Emergency Medicine, University of Utah, Salt Lake City, UT;1. Department of Heart and Vessels, Cardiac Surgery Unit, Varese University Hospital, Varese, Italy;2. Department of Surgical and Morphological Sciences, Cardiac Surgery Unit, Varese University Hospital, University of Insubria, Varese, Italy;3. Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland;4. Department of Heart and Vessels, Vascular Surgery Unit, Varese University Hospital, Italy;5. Department of Cardiac Surgery, Cardiocentro Ticino, Lugano, Switzerland |
| |
Abstract: | ObjectivesSevere acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality.MethodsIn this retrospective propensity score–matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72 hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS).ResultsStage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P < .001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71–3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45).ConclusionsStage 1 AKI is independently associated with postoperative infection, ICU LOS, and hospital LOS. Treatment strategies focused on prevention, early recognition, and optimal medical management of AKI may decrease significant postoperative morbidity. |
| |
Keywords: | acute kidney injury postoperative infection cardiopulmonary bypass postoperative complications propensity-score matching cardiac surgery AKI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0020" }," $$" :[{" #name" :" text" ," _" :" acute kidney injury CABG" },{" #name" :" keyword" ," $" :{" id" :" kwrd0030" }," $$" :[{" #name" :" text" ," _" :" coronary artery bypass grafting CI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" confidence interval KDIGO" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" Kidney Disease Improving Global Outcomes ICU" },{" #name" :" keyword" ," $" :{" id" :" kwrd0060" }," $$" :[{" #name" :" text" ," _" :" intensive care unit LOS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0070" }," $$" :[{" #name" :" text" ," _" :" length of stay OR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0080" }," $$" :[{" #name" :" text" ," _" :" odds ratio STS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0090" }," $$" :[{" #name" :" text" ," _" :" Society of Thoracic Surgeons |
本文献已被 ScienceDirect 等数据库收录! |
|