Acute Kidney Injury, Coronary Artery Bypass, Off-Pump, Intraoperative Hypotension
Conditions
Keywords
Coronary Artery Bypass, Off-Pump, Intraoperative Hypotension, Acute Kidney Injury
Brief summary
Acute renal injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. Hypotension is an important risk factor for the development of AKI after noncardiac surgery. However, the association between intraoperative hypotension and AKI after cardiac surgery has not been fully investigated. The purpose of this study is to analyze the association between intraoperative hypotension and acute kidney injury after off-pump coronary artery bypass surgery.
Detailed description
Acute renal injury (AKI) is a common complication after cardiac surgery. Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with increased in-hospital mortality, prolonged length of stay in the Intensive Care Unit and hospital, and higher costs of care. Intraoperative hypotension is an important risk factor for the development of AKI after noncardiac surgery. In a retrospective analysis, a mean arterial pressure of less than 55 mmHg predicted the occurrence of adverse cardiac- and renal-related outcomes after noncardiac surgery. Other studies also revealed that intraoperative hypotension is associated with increased incidence of AKI and 1-year mortality after noncardiac surgery. In patients undergoing cardiac surgery, 30-day mortality is proportionate to the extent of systolic blood pressure excursions outside the range of 75 to 135 mm Hg intraoperatively. However, the correlation between intraoperative hypotension and the development of AKI after cardiac surgery has not been fully investigated. The purpose of this study is to analyze the association between intraoperative hypotension and the risk of acute kidney injury after off-pump coronary artery bypass surgery.
Interventions
None listed
Sponsors
Peking University First Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 50 years; * Underwent off-pump CABG surgery.
Exclusion criteria
* End-stage renal disease requiring renal-replacement therapy; * Emergency surgery; * Kidney transplantation within 3 months; * Missing data.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of acute kidney injury (AKI) within 7 days after surgery | Up to 7 days after surgery | Development of AKI within 7 days after surgery is diagnosed according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of mechanical ventilation after surgery | Up to 30 days after surgery | Duration of mechanical ventilation after surgery |
| Length of stay in hospital after surgery | Up to 30 days after surgery | Length of stay in hospital after surgery |
| Length of stay in intensive care unit (ICU) after surgery | Up to 30 days after surgery | Length of stay in intensive care unit (ICU) after surgery |
| Classification of AKI within 7 days after surgery | Up to 7 days after surgery | Development of AKI within 7 days after surgery is diagnosed according to the KDIGO criteria |
| Incidence of non-MACE complications within 30 days after surgery | Up to 30 days after surgery | Non-MACE complications within 30 days after surgery indicate new-onset medical conditions other than MACEs that produce harmful effects on patients' recovery and required therapeutic intervention. |
| All-cause mortality in hospital | Up to 30 days after surgery | All-cause mortality in hospital |
| Incidence of major adverse cardiovascular events (MACEs) within 30 days after surgery | Up to 30 days after surgery | MACEs within 30 days after surgery include cardiovascular death, non-fatal cardiac arrest, acute myocardial infarction, revascularization, and ischemic stroke. |
Countries
China
Outcome results
None listed