PMID- 34422369
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220426
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 13
IP  - 7
DP  - 2021 Jul
TI  - The prognosis and risk factors for acute kidney injury in high-risk patients 
      after surgery for type A aortic dissection in the ICU.
PG  - 4427-4437
LID - 10.21037/jtd-21-823 [doi]
AB  - BACKGROUND: Acute kidney injury (AKI) is a major complication of cardiac surgery, 
      with high rates of morbidity and mortality. The aim of this study was to identify 
      risk factors for the incidence and prognosis of AKI in high-risk patients before 
      and after surgery for acute type A aortic dissection (TAAD) in the intensive care 
      unit (ICU). METHODS: We performed a retrospective cohort study from April 2018 to 
      April 2019. The primary end points of this study were morbidity due to AKI and 
      risk factors for incidence, and the secondary end points were mortality at 28 
      days and risk factors for death. RESULTS: We enrolled 60 patients, 52 (86.67%) 
      patients developed postoperative AKI, 28 (53.84%) patients died. Preoperative 
      lactic acid level (P=0.022) and cardiopulmonary bypass (CPB) duration (P=0.009) 
      were identified as independent risk factors for postoperative AKI. The 28-day 
      mortality for postoperative patients with TAAD was 46.67%, 53.84% for those with 
      TAAD and AKI, 67.5% for those who required continue renal replacement therapy 
      (CRRT). The risk factors for 28-day mortality due to postoperative AKI for 
      patients requiring CRRT were CPB duration (P=0.019) and norepinephrine dose upon 
      diagnosis of AKI (P=0.037). CONCLUSIONS: Morbidity due to AKI in postoperative 
      patients with TAAD was 86.67%, and preoperative lactic acid level and CPB 
      duration were independent risk factors. The 28-day mortality of postoperative 
      patients with TAAD was 46.67%, 53.84% for those with TAAD and AKI, and 67.5% for 
      those requiring CRRT. CPB duration and norepinephrine dose upon diagnosis of AKI 
      may influence patients' short-term prognosis.
CI  - 2021 Journal of Thoracic Disease. All rights reserved.
FAU - Zhang, Kun
AU  - Zhang K
AD  - Intensive Care Unit, Hebei Medical University Fourth Affiliated Hospital and 
      Hebei Provincial Tumor Hospital, Shijiazhuang, China.
FAU - Shang, Jiuyan
AU  - Shang J
AD  - Department of Pathology, Hebei Medical University Fourth Affiliated Hospital and 
      Hebei Provincial Tumor Hospital, Shijiazhuang, China.
FAU - Chen, Yuhong
AU  - Chen Y
AD  - Intensive Care Unit, Hebei Medical University Fourth Affiliated Hospital and 
      Hebei Provincial Tumor Hospital, Shijiazhuang, China.
FAU - Huo, Yan
AU  - Huo Y
AD  - Intensive Care Unit, Hebei Medical University Fourth Affiliated Hospital and 
      Hebei Provincial Tumor Hospital, Shijiazhuang, China.
FAU - Li, Bin
AU  - Li B
AD  - Intensive Care Unit, Hebei Medical University Fourth Affiliated Hospital and 
      Hebei Provincial Tumor Hospital, Shijiazhuang, China.
FAU - Hu, Zhenjie
AU  - Hu Z
AD  - Intensive Care Unit, Hebei Medical University Fourth Affiliated Hospital and 
      Hebei Provincial Tumor Hospital, Shijiazhuang, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC8339792
OTO - NOTNLM
OT  - Intensive care unit (ICU)
OT  - acute kidney injury (AKI)
OT  - continue renal replacement therapy (CRRT)
OT  - type A aortic dissection (TAAD)
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at https://dx.doi.org/10.21037/jtd-21-823). The authors have no 
      conflicts of interest to declare.
EDAT- 2021/08/24 06:00
MHDA- 2021/08/24 06:01
PMCR- 2021/07/01
CRDT- 2021/08/23 06:32
PHST- 2021/02/03 00:00 [received]
PHST- 2021/07/13 00:00 [accepted]
PHST- 2021/08/23 06:32 [entrez]
PHST- 2021/08/24 06:00 [pubmed]
PHST- 2021/08/24 06:01 [medline]
PHST- 2021/07/01 00:00 [pmc-release]
AID - jtd-13-07-4427 [pii]
AID - 10.21037/jtd-21-823 [doi]
PST - ppublish
SO  - J Thorac Dis. 2021 Jul;13(7):4427-4437. doi: 10.21037/jtd-21-823.