Prognosis of acute kidney injury requiring renal replacement therapy in patients undergoing surgery for Stanford type A aortic dissection
10.3760/cma.j.issn.1001-4497.2014.06.009
- VernacularTitle:Stanford A型主动脉夹层术后急性肾损伤行肾脏替代治疗患者的预后
- Author:
Xiaomei YANG
;
Lan LIU
;
Yamin ZHUANG
;
Ying ZHANG
;
Hua LIU
;
Jian GAO
;
Chunsheng WANG
- Publication Type:Journal Article
- Keywords:
Aneurysm,dissecting;
Renal insufficiency,acute;
Renal replacement therapy;
Prognosis
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2014;30(6):346-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective Acute kidney injury(AKI) is a common and serious complication with high morbidity and mortality in patients undergoing surgery for Stanford type A aortic dissection.The purpose of this study is to investigate the mortality and risk factors for the prognosis of AKI requiring renal replacement therapy(RRT) in patients undergoing surgery for Stanford type A aortic dissection.Methods We retrospectively investigated 68 patients of AKI requiring RRT undergoing surgery for Stanford type A aortic dissection in Zhongshan Hospital from October 2005 to May 2013.The mean age was (55.31 ± 11.08) years.The patients were divided into two groups,survivors(n =40) and non-survivors(n =28).We observed the clinical data of the patients in both groups.Univariate and multivariate analyses were performed to investigate the risk factors for prognosis of AKI requiring RRT.Results Of the 68 patients,28 patients died.The in-hospital mortality was 41.18％.Univariate analysis showed the following as significant risk factors:APACHE Ⅱ score,hypotension,gastrointestinal bleeding,hepatic dysfunction,neurological deficits(P ＜ 0.05).Multivariable Cox regression analysis identified New York Heart Association (NYHA) functional class Ⅳ (HR 5.486,95 ％ CI 1.805-16.676),APACHE Ⅱ score (HR 1.123,95％ CI 1.055-1.196),hypotension (HR 3.328,95％ CI 1.180-9.382),hepatic dysfunction(HR 2.242,95％ CI 1.015-4.952) were independent predictors of in-hospital mortality (P ＜ 0.05).Conclusion AKI requiring RRT after Stanford type A aortic dissection surgery is associated with high mortality.Risk factors of death should be taken into consideration for perioperative care and may improve clinical outcome.
