TY - JOUR
T1 - Long-term outcomes of acute kidney injury after different types of cardiac surgeries
T2 - A population-based study
AU - Chen, Jia Jin
AU - Chang, Chih Hsiang
AU - Wu, Victor Chien Chia
AU - Chang, Shang Hung
AU - Hung, Kuo Chun
AU - Chu, Pao Hsien
AU - Chen, Shao Wei
N1 - Publisher Copyright:
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. T.
PY - 2021/5/4
Y1 - 2021/5/4
N2 - BACKGROUND: Dialysis-requiring acute kidney injury (D-AKI) is a major complication of cardiovascular surgery that results in worse prognosis. However, the incidence and impacts of D-AKI in different types of cardiac surgeries have not been fully investigated. METHODS AND RESULTS: Patients admitted for cardiovascular surgery between July 1, 2004, and December 31, 2013, were identified from the National Health Insurance Research Database of Taiwan. The patients were grouped into D-AKI (n=3089) and non– D-AKI (n=42 151) groups. The outcome was all-cause mortality and major adverse kidney event. The long-term outcomes were worse in the D-AKI group than the non– D-AKI group (hazard ratio [HR], 3.89; 95% CI, 3.79– 3.99 for major adverse kidney event; HR, 2.89; 95% CI, 2.81– 2.98 for all-cause mortality). Patients who underwent aortic surgery had higher risk for D-AKI than other types of surgeries, but they were also more likely to recover. The long-term dialysis rate for the patients who recovered from D-AKI was also lowest in those who underwent aortic surgery. Among all types of cardiac surgeries with D-AKI, patients who had heart valve surgery exhibited the greatest risks of all-cause mortality (HR, 6.04; 95% CI, 5.78– 6.32). CONCLUSIONS: Compared with other heart surgeries, aortic surgery resulted in a higher incidence of D-AKI but better renal recovery, better short-term outcome, and lower incidences of long-term dialysis.
AB - BACKGROUND: Dialysis-requiring acute kidney injury (D-AKI) is a major complication of cardiovascular surgery that results in worse prognosis. However, the incidence and impacts of D-AKI in different types of cardiac surgeries have not been fully investigated. METHODS AND RESULTS: Patients admitted for cardiovascular surgery between July 1, 2004, and December 31, 2013, were identified from the National Health Insurance Research Database of Taiwan. The patients were grouped into D-AKI (n=3089) and non– D-AKI (n=42 151) groups. The outcome was all-cause mortality and major adverse kidney event. The long-term outcomes were worse in the D-AKI group than the non– D-AKI group (hazard ratio [HR], 3.89; 95% CI, 3.79– 3.99 for major adverse kidney event; HR, 2.89; 95% CI, 2.81– 2.98 for all-cause mortality). Patients who underwent aortic surgery had higher risk for D-AKI than other types of surgeries, but they were also more likely to recover. The long-term dialysis rate for the patients who recovered from D-AKI was also lowest in those who underwent aortic surgery. Among all types of cardiac surgeries with D-AKI, patients who had heart valve surgery exhibited the greatest risks of all-cause mortality (HR, 6.04; 95% CI, 5.78– 6.32). CONCLUSIONS: Compared with other heart surgeries, aortic surgery resulted in a higher incidence of D-AKI but better renal recovery, better short-term outcome, and lower incidences of long-term dialysis.
KW - Acute kidney injury
KW - Cardiac surgery
KW - Cardiovascular
KW - Dialysis
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85106068994&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.019718
DO - 10.1161/JAHA.120.019718
M3 - 文章
C2 - 33880935
AN - SCOPUS:85106068994
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 9
M1 - e019718
ER -