Journal of cardiac surgery · 2013
Risk factors for acute kidney injury in patients undergoing same admission coronary angiography and valve replacement.
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Hu Yijie, Li Zhiping, Chen Jianming, Shen Cheng, Song Yi, Zhong Qianjin
Аннотация
BACKGROUND: We investigated risk factors for acute kidney injury (AKI) in patients undergoing same admission coronary angiography (CAG) and valve replacement.
METHODS: Among 283 consecutive patients undergoing valve surgery between October 2010 and July 2012, 71 patients with same admission preoperative CAG were included in the study. Predictors of AKI were identified with a univariable model; then, logistic regression analysis was performed with the variables with p < 0.1 in univariable analysis and other known risk factors of AKI.
RESULTS: Twenty-two (31.0%) patients developed AKI. Univariate analysis revealed that diabetes mellitus (p = 0.097), cerebrovascular disease (p = 0.03), atrial fibrillation (p = 0.097), one-stage procedure (p = 0.05), and concomitant tricuspid valvular replacement/repair (p = 0.033) were risk factors. Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [OR] 10.361, 95% CI 1.345-79.828, p = 0.025) and cerebrovascular disease (OR 26.070, 95% CI 1.695-400.939, p = 0.019) are risk factors for AKI in patients 50 years or older undergoing same admission CAG and valve replacement. One-stage procedure was not associated with a higher incidence of AKI.
CONCLUSION: Diabetes mellitus and cerebrovascular disease are risk factors for AKI. Same admission CAG and valve replacement should be performed with caution in this group of patients.
METHODS: Among 283 consecutive patients undergoing valve surgery between October 2010 and July 2012, 71 patients with same admission preoperative CAG were included in the study. Predictors of AKI were identified with a univariable model; then, logistic regression analysis was performed with the variables with p < 0.1 in univariable analysis and other known risk factors of AKI.
RESULTS: Twenty-two (31.0%) patients developed AKI. Univariate analysis revealed that diabetes mellitus (p = 0.097), cerebrovascular disease (p = 0.03), atrial fibrillation (p = 0.097), one-stage procedure (p = 0.05), and concomitant tricuspid valvular replacement/repair (p = 0.033) were risk factors. Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [OR] 10.361, 95% CI 1.345-79.828, p = 0.025) and cerebrovascular disease (OR 26.070, 95% CI 1.695-400.939, p = 0.019) are risk factors for AKI in patients 50 years or older undergoing same admission CAG and valve replacement. One-stage procedure was not associated with a higher incidence of AKI.
CONCLUSION: Diabetes mellitus and cerebrovascular disease are risk factors for AKI. Same admission CAG and valve replacement should be performed with caution in this group of patients.