Predictors of postoperative severe acute kidney injury requiring continuous renal replacement treatment in patients with acute A aortic dissection undergoing Sun's operation
10.3760/cma.j.issn.1001-4497.2019.04.005
- VernacularTitle:急性A型主动脉夹层行孙氏手术术后急性肾损伤需持续血液透析治疗相关风险因素分析
- Author:
Xing HAO
1
;
Xiaomeng WANG
;
Chenglong LI
;
Chunjing JIANG
;
Liangshan WANG
;
Feng YANG
;
Hong WANG
;
Xiaotong HOU
Author Information
1. 首都医科大学附属北京安贞医院心脏外科危重症中心 100029
- Keywords:
Acute A aortic dissections;
Acute kidney injury;
Continuous renal replacement therapy;
Risk factor
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2019;35(4):213-217
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the incidence and risk factors of acute kidney injury(AKI) requiring continuous renal replacement treatment(CRRT) in patients with acute type A aortic dissection after Sun's operation.Methods A retrospective analysis of consecutive patients with acute type A aortic dissection underwent Sun's operation in Beijing Anzhen Hospital,Capital Medical University from January 2009 to December 2015.These patients were divided into two groups according to whether had severe postoperative AKI requiring CRRT treatment:the dialysis group(AG,65 cases) and the control group(CG,618 cases),we compared the clinical outcomes of patients in two groups and analyzed the related risk factors.Results 50 patients(7.3％) died in hospital.Compared with patients in CG group,patients in AG group had higher age,more patients with preoperative coronary heart disease,pericardial tamponade,and higher rates of intraoperative coronary artery hypass surgery or valve surgery,the results were statistically different between the two groups(P ＜0.05).The patients in AG group had a higher mortality rate in hospital(26.2％ vs.5.3％),and the difference was statistically significant(P ＜0.001).The results of multiple regression analysis suggested that the age ＞ 50 years,preoperative history of pericardial tamponade,intraoperative need for combined coronary artery bypass grafting or valve surgery,and cerebral perfusion time ＞40 min were independent risk factors for CRRT treatment of postoperative severe AKI(P ＜0.05).Conclusion The incidence of severe AKI requiring CRRT treatment in patients with acute type A aortic dissection after Sun's operation was 9.5％,and the discharge survival rate in AG group was lower than that in CG group.An important way to reduce the incidence of severe AKI requiring CRRT after sun's surgery is to shorten the intraoperative cerebral perfusion time as much as possible.
