Cardiopulmonary bypass time is an independent risk factor for acute kidney injury in emergent thoracic aortic surgery: a retrospective cohort study

Abstract

Background Thoracic aortic surgery and cardiopulmonary bypass are both associated with development of postoperative acute kidney injury. In this study, we undertook to investigate the relationship between cardiopulmonary bypass time and postoperative acute kidney injury in patients undergoing thoracic aortic surgery for acute DeBakey Type I aortic dissection. Methods All patients receiving thoracic aortic surgery for acute DeBakey Type I aortic dissection in Beijing Anzhen hospital from December 2015 to April 2017 were included. Cardiopulmonary bypass time was recorded during surgery. Acute kidney injury was defined based on the Kidney Disease Improving Global Outcomes criteria. A total of 115 consecutive patients were eventually analyzed. Results The overall incidence of acute kidney injury was 53.0% ( n = 61). The average age was 47.8 ± 10.7 years; 74.8% were male. Mean cardiopulmonary bypass time was 211 ± 56 min. In-hospital mortality was 7.8%. Multivariate logistic regression revealed that cardiopulmonary bypass time was independently associated with the occurrence of postoperative acute kidney injury after adjust confounding factors (odds ratio = 1.171; 95% confidence interval: 1.002–1.368; P = 0.047). Conclusions Cardiopulmonary bypass time is independently associated with an increased hazard of acute kidney injury after thoracic aortic surgery for acute DeBakey Type I aortic dissection. Further understanding of the mechanism of this association is crucial to the design of preventative strategies. Electronic supplementary material The online version of this article (10.1186/s13019-019-0907-x) contains supplementary material, which is available to authorized users.

Characteristics and outcomes of Stanford type A aortic dissection patients with severe post-operation hyperbilirubinemia: a retrospective cohort study

“…The analysis of our present cohort of AAD patients with severe post-operation hyperbilirubinemia showed an overall incidence of post-operation AKI of 81.9%, a requirement for CRRT of 18.5%, and the in-hospital mortality increased from 14 % in all patients to 30.3% in those with post-operative hyperbilirubinemia. In previous studies of AAD patients underwent surgical treatment without severe post-operation hyperbilirubinemia, the reported AKI incidences were ranged from 40% to 78%, [17][18][19][20][21][22][23][24][25] the reported incidences of requirement for CRRT were ranged from 3% to 8%, [21,25] and the reported in-hospital mortalities were ranged from 15% to 26%. [18,21,[25][26][27] The discrepancy most likely attributed to the fact that all of the included AAD patients in our study developed severe hyperbilirubinemia.…”

Characteristics and outcomes of Stanford type A aortic dissection patients with severe post-operation hyperbilirubinemia: a retrospective cohort study

“…The analysis of our present cohort of AAD patients with severe post-operation hyperbilirubinemia showed an overall incidence of post-operation AKI of 81.9%, a requirement for CRRT of 18.5%, and the in-hospital mortality increased from 14% in all patients to 30.3% in those with post-operative hyperbilirubinemia. In previous studies of AAD patients underwent surgical treatment without severe post-operation hyperbilirubinemia, the reported AKI incidences were ranged from 40 to 78% [17][18][19][20][21][22][23][24][25], the reported incidences of requirement for CRRT were ranged from 3 to 8% [21,25], and the reported in-hospital mortalities were ranged from 15 to 26% [18,21,[25][26][27]. The discrepancy most likely attributed to the fact that all of the included AAD patients in our study developed severe hyperbilirubinemia.…”

Characteristics and outcomes of Stanford type A aortic dissection patients with post-operation severe hyperbilirubinemia: a retrospective cohort study

“…The analysis of our present cohort of AAD patients with post-operation severe hyperbilirubinemia showed an overall incidence of post-operation AKI of 81.9%, a requirement for CRRT of 18.5%, and the in-hospital mortality rate of 30.3%. In previous studies of AAD patients underwent surgical treatment without post-operation severe hyperbilirubinemia, the reported AKI incidences were ranged from 40-78%, [5][6][7][18][19][20][21][22][23] the reported incidences of requirement for CRRT were ranged from 3% to 8%, [5,7] and the reported in-hospital mortalities were ranged from 15-26%. [4,5,7,19,24] The discrepancy most likely attributed to the fact that all of the included AAD patients in our study developed severe hyperbilirubinemia.…”