297 探究心脏手术患者急性肾损伤的风险因素

IF 8.6 1区 医学 Q1 SURGERY British Journal of Surgery Pub Date : 2024-07-01 DOI:10.1093/bjs/znae163.096
E. Abelian, M. Bhandari, R. Purmessur, J. Ali
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引用次数: 0

摘要

急性肾损伤(AKI)是心脏手术后的一种重要并发症,与不良预后有关。这项工作的目的是调查在我们中心接受心脏手术的患者中急性肾损伤的发生率和风险因素。 这是一项回顾性分析,研究对象是在一年时间内接受了使用心肺旁路的择期或紧急(但非急诊)心血管手术的 1441 名患者。我们的排除标准是心脏移植、单次 CABG、先天性修复或术前接受透析或肾移植的患者。数据分析在 R studio 中进行。 患者的平均年龄为 67.7 岁。术前 7 天的平均肌酐为 90 微摩尔/升,而术后的平均峰值肌酐为 127 微摩尔/升(95% CI 33-42,P 值<0.05)。根据 KDIGO AKI 分期的定义,27% 的患者出现 AKI 1 期,11% 的患者出现 AKI 2 期,1% 的患者出现 AKI 3 期。以下变量与术后发生 AKI 的风险密切相关(P 值<0.001):糖尿病、吸烟和外周血管疾病等合并症;术前用药:利尿剂、钙通道阻滞剂和 SGLT-2 抑制剂;术后接受全血细胞或红细胞输注。 AKI 是心脏手术后常见的并发症。了解 AKI 的风险因素可以为术前干预提供机会,还可以突出围手术期可能需要格外警惕的患者,以减少其发生率,从而改善术后效果。
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297 Exploring Risk Factors for Acute Kidney Injury in Patients Undergoing Cardiac Surgery
Acute Kidney Injury (AKI) is an important complication following cardiac surgery that has been associated with adverse outcomes. The aim of this work was to investigate the incidence and risk factors for AKI in patients undergoing cardiac surgery at our centre. This is a retrospective analysis of 1441 patients who underwent elective or urgent (but not emergency) cardiovascular surgery with use of cardiopulmonary bypass over a 1-year period. Our exclusion criteria were heart transplant, single CABG, congenital repairs or patients on dialysis or renal transplant pre-operatively. Data analysis was performed in R studio. The mean age of the patients was 67.7 years. Mean creatinine from a 7-day period before surgery was 90µmol/L compared with the mean peak post operative creatinine of 127 µmol/L (95% CI 33-42, p-value <0.05). As defined by the KDIGO AKI stages, 27% developed an AKI stage 1, 11% developed AKI stage 2 and 1% AKI stage 3. The following variables correlated strongly (P-value <0.001) with post-operative risk of AKI: The comorbidities of diabetes, smoking, and peripheral vascular disease; pre-operative medications: diuretics, calcium channel blockers and SGLT-2 inhibitors and receiving FFP or RBC transfusion postoperatively. AKI is a common complication following cardiac surgery. Having an insight into the risk factors for AKI allows an opportunity for intervention preoperatively and can also highlight patients that may require extra vigilance in the perioperative period to reduce its incidence, which may lead to an improvement in outcomes following surgery.
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来源期刊
CiteScore
12.70
自引率
7.30%
发文量
1102
审稿时长
1.5 months
期刊介绍: The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology. While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.
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