Stage 1 acute kidney injury is independently associated with infection following cardiac surgery
Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved..
OBJECTIVES: Severe acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality.
METHODS: In this retrospective propensity score-matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72 hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS).
RESULTS: Stage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P < .001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71-3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45).
CONCLUSIONS: Stage 1 AKI is independently associated with postoperative infection, ICU LOS, and hospital LOS. Treatment strategies focused on prevention, early recognition, and optimal medical management of AKI may decrease significant postoperative morbidity.
| Errataetall: |
CommentIn: J Thorac Cardiovasc Surg. 2021 Apr;161(4):1356-1357. - PMID 31926711 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:161 |
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| Enthalten in: |
The Journal of thoracic and cardiovascular surgery - 161(2021), 4 vom: 29. Apr., Seite 1346-1355.e3 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Griffin, Benjamin R [VerfasserIn] |
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| Links: |
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| Themen: |
Acute kidney injury |
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| Anmerkungen: |
Date Completed 29.03.2021 Date Revised 02.04.2022 published: Print-Electronic CommentIn: J Thorac Cardiovasc Surg. 2021 Apr;161(4):1356-1357. - PMID 31926711 Citation Status MEDLINE |
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| doi: |
10.1016/j.jtcvs.2019.11.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM306028891 |
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| 245 | 1 | 0 | |a Stage 1 acute kidney injury is independently associated with infection following cardiac surgery |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Thorac Cardiovasc Surg. 2021 Apr;161(4):1356-1357. - PMID 31926711 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVES: Severe acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality | ||
| 520 | |a METHODS: In this retrospective propensity score-matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72 hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS) | ||
| 520 | |a RESULTS: Stage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P < .001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71-3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45) | ||
| 520 | |a CONCLUSIONS: Stage 1 AKI is independently associated with postoperative infection, ICU LOS, and hospital LOS. Treatment strategies focused on prevention, early recognition, and optimal medical management of AKI may decrease significant postoperative morbidity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a acute kidney injury | |
| 650 | 4 | |a cardiac surgery | |
| 650 | 4 | |a cardiopulmonary bypass | |
| 650 | 4 | |a postoperative complications | |
| 650 | 4 | |a postoperative infection | |
| 650 | 4 | |a propensity-score matching | |
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| 700 | 1 | |a Ambruso, Sophia |e verfasserin |4 aut | |
| 700 | 1 | |a Bronsert, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Pal, Jay D |e verfasserin |4 aut | |
| 700 | 1 | |a Cleveland, Joseph C |e verfasserin |4 aut | |
| 700 | 1 | |a Reece, T Brett |e verfasserin |4 aut | |
| 700 | 1 | |a Fullerton, David A |e verfasserin |4 aut | |
| 700 | 1 | |a Faubel, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Aftab, Muhammad |e verfasserin |4 aut | |
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