Ried, Michael and Puehler, Thomas and Haneya, Assad and Schmid, Christof and Diez, Claudius (2011) Acute kidney injury in septua- and octogenarians after cardiac surgery. BMC CARDIOVASCULAR DISORDERS, 11: 52. ISSN 1471-2261,
Full text not available from this repository. (Request a copy)Abstract
Background: An increasing number of septua- and octogenarians undergo cardiac surgery. Acute kidney injury (AKI) still is a frequent complication after surgery. We examined the incidence of AKI and its impact on 30-day mortality. Methods: A retrospective study between 01/2006 and 08/2009 with 299 octogenarians, who were matched for gender and surgical procedure to 299 septuagenarians at a university hospital. Primary endpoint was AKI after surgery as proposed by the RIFLE definition (Risk, Injury, Failure, Loss, End-stage kidney disease). Secondary endpoint was 30-day mortality. Perioperative mortality was predicted with the logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE). Results: Octogenarians significantly had a mean higher logistic EuroSCORE compared to septuagenarians (13.2% versus 8.5%; p < 0.001) and a higher proportion of patients with an estimated glomerular filtration rate (eGFR) < 60 ml x min(-1) x 1.73 m(-2). In contrast, septuagenarians showed a slightly higher median body mass index (28 kg x m(-2) versus 26 kg x m-2) and were more frequently active smoker at time of surgery (6.4% versus 1.6%, p < 0.001). Acute kidney injury and failure developed in 21.7% of septuagenarians and in 21.4% of octogenarians, whereas more than 30% of patients were at risk for AKI (30% and 36.3%, respectively). Greater degrees of AKI were associated with a stepwise increase in risk for death, renal replacement therapy and prolonged stays at the intensive care unit and at the hospital in both age groups, but without differences between them. Overall 30-day mortality was 6% in septuagenarians and 7.7% in octogenarians (p = 0.52). The RIFLE classification provided accurate risk assessment for 30-day mortality and fair discriminatory power. Conclusions: The RIFLE criteria allow identifying patients with AKI after cardiac surgery. The high incidence of AKI in septua- and octogenarians after cardiac surgery should prompt the use of RIFLE criteria to identify patients at risk and should stimulate institutional measures that target AKI as a quality improvement initiative for patients at advanced age.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE-RENAL-FAILURE; POPULATION; PROGNOSIS; MORTALITY; DYSFUNCTION; SURVIVAL; DIALYSIS; CRITERIA; IMPACT; VALVE; Acute kidney injury; cardiac surgery; extracorporeal circulation; mortality; septuagenarians; octogenarians |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 03 Jun 2020 05:36 |
| Last Modified: | 03 Jun 2020 05:36 |
| URI: | https://pred.uni-regensburg.de/id/eprint/20402 |
Actions (login required)
 |
View Item |
