Acute kidney injury following coronary artery bypass graft surgery in a tertiary public hospital in Malaysia: an analysis of 1228 consecutive cases
- Author:
Hiew Khee Chun
;
Anand Sachithanandan
;
Mohamad Arif Muhammad Nor
;
Balaji Badmanaban
;
Abdul Muiz Jasid
;
Faisal Ismail
;
Hamdan Leman
;
Evi Diana Omar
- Publication Type:Journal Article
- Keywords:
Acute kidney injury;
AKI;
CABG;
Coronary artery bypass graft;
Southeast Asian
- MeSH:
Acute Kidney Injury
- From:
The Medical Journal of Malaysia
2016;71(3):126-130
- CountryMalaysia
- Language:English
-
Abstract:
Background: Acute kidney injury (AKI) following cardiac
surgery is well established but the reported incidence is
variable due to varying definitions and criteria. Furthermore
there is a paucity of such data from Southeast Asia.
Objectives: To determine the incidence of AKI, the
associated risk factors, and its impact on early mortality and
intensive care unit/hospital stay.
Method: This is a single centre retrospective observational
study to evaluate outcomes on 1260 consecutive patients
from a multi-ethnic Southeast Asian population who
underwent a primary isolated coronary artery bypass graft
(CABG) operation. Data was collected from the hospital’s
electronic database and analysed using basic descriptive
statistics and logistic regression.
Results: Overall incidence was 36.2% including 5.5% of
patients who required renal replacement therapy (RRT).
Multivariate analysis identified age, insulin-dependent
diabetes mellitus (IDDM), baseline serum creatinine level
(SCr), recent myocardial infarction (MI), cardiopulmonary
bypass (CPB) time and intra-aortic balloon pump (IABP) use
as independent risk factors for AKI. For patients who
required RRT, the SCr and IDDM remained independent
predictors. Early 30-day mortality (11.5% vs 0.9%) was
significantly higher in patients who developed AKI following
CABG. Similarly, AKI was associated with a slight but
statistically significant increase in intensive care unit (ICU)
and hospital stay.
Conclusion: Better prognostication and preventative
strategies are required to better risk stratify patients
undergoing CABG and optimise utilisation of limited
healthcare resources.
- Full text:P020160811613063284833.pdf
