Impact of Acute Kidney Injury on One-Year Survival After Surgery for Aortic Dissection

Acute Kidney Injury and Long-term Risk of Cardiovascular Events After Cardiac Surgery: A Population-Based Cohort Study

“…4,5,[11][12][13] In a previous, smaller study, the authors found indication of an increased 5-year risk of myocardial infarction, and this association is now supported by the findings in the present population-based study. 4 Tsai et al found an adjusted 1-year HR of 2.6 (95% CI: 1.0-6.3) for myocardial infarction after aortic dissection comparing AKI patients with non-AKI patients.…”

“…Total follow-up time was 12,476 person-years with median duration of 2.7 years (interquartile range [IQR]: 1.2-4.1). Median duration from day of surgery until hospital discharge for non-AKI patients was 8 days (IQR: 6-11) and for AKI patients was 13 days (IQR 9-20), ranging from 11 days (IQR: [8][9][10][11][12][13][14][15][16] in patients with AKI stage 1 to 21 days (IQR: 12-37) for patients with AKI stages 2þ3.…”

“…10 Recent studies examining the long-term (beyond 90 days) prognosis of AKI after cardiac surgery have found an association with myocardial infarction and heart failure, but not with stroke. 4,5,[11][12][13] The time windows used to define AKI in these studies differ (5,7, and 30 days), which hampers comparison because the reason for AKI may change during the postoperative period. Early-onset AKI supposedly is related to perioperative stress (including hemodynamics); while late-onset AKI is more likely a consequence of complications, including both cardiac complications and infections/sepsis.…”

Risk factors for acute kidney injury after initial acute aortic dissection and their effect on long-term mortality

“…Several risk factors for in-hospital and long-term mortality have been reported [2][3][4][5][6][7][8]. Acute kidney injury (AKI) after acute aortic dissection and cardiothoracic surgery are predictive factors for mortality [9][10][11][12][13]. Several mechanisms for AKI after aortic dissection and surgery have been reported.…”

“…Other reports suggest that cardiac and cerebral malperfusion are both risk factors for in-hospital mortality; the order of importance of malperfusion is as follows: cardiac, cerebral, ileofemoral, renal, mesenteric, innominate, and spine [15]. Emergency surgery for type A aortic dissection using circulatory arrest influences AKI [9], and the mortality increases with severity of AKI [13,16,17]. Systemic mild-to-moderate hypothermia adapted to the duration of circulatory arrest is an effective method of organ protection in cardiovascular surgery [18], but deep hypothermia is associated with a greater risk of postoperative low cardiac output syndrome [19].…”