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Volume 3 Supplement 1

ESICM LIVES 2015

  • Oral presentation
  • Open Access

Prognostic Factors in The Development of Permanent Renal Injury in Patients Undergoing Cardiac Surgery

  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Intensive Care Medicine Experimental20153 (Suppl 1) :A14

https://doi.org/10.1186/2197-425X-3-S1-A14

  • Published:

Keywords

  • Prognostic Factor
  • Risk Stratification
  • Care Plan
  • Binary Logistic Regression
  • Renal Injury

Introduction

Renal injury is a frequent and serious complication in patients undergoing cardiac surgery. This injury usually recover completely. However, according to recently published data, a significant number of patients with this lesion remain at hospital discharge.

Objective

To analyze patients undergoing cardiac surgery in our hospital to determine whether there prognostic factors for the development of permanent kidney damage.

Methods

We use data base Andalusian registry of cardiac surgery in the comprehensive care plan to heart disease, referring to patients operated in our hospital and admitted to our intensive care unit of the” Hospital Virgen de las Nieves” of Granada, between June 2008 until the end of 2014.

Results

A total of 2,443 patients underwent cardiac surgery and discharged from hospital alive. of these 1,497 had prior to surgery normal renal function (defined by plasma creatinine ≤ 1.2 mg). a total of 149 were discharged with plasma creatinine levels that exceeded 0.3 mg baseline and / or an increase of 50% of these values, regardless of what happened during their hospital stay.

The main baseline characteristics of patients with and without renal injury were (table 1)

By adjusting a model of binary logistic regression (table 2) with the variables age, diagnostic group, NYHA class, character surgery, COPD (cronic obstructive pulmonary disease), Diabetes, ejection fraction and EuroSCORE is obtained that the variables that are significantly associated with the development of renal injury are age (most significant), COPD and NYHA class.

Table 1

 

No (1678)

 

Yes (149)

  
 

Media

sd

Media

sd

p

Age

61,44

13,59

67,30

10,64

,000

Preoperative creatinine

,89

,17

,86

,19

,05

Ejection fraction

59,25

10,52

57,43

11,07

,04

CPB time

112,37

45,91

108,14

42,94

,3

Aortic clamp time

85,61

38,33

86,09

38,47

,88

Discharge creatinine

,80

,20

1,49

,77

,000

EuroSCORE Log

6,94

7,85

9,55

11,38

,000

Table 2

 

No n

No %

Yes n

Yes %

p

Diabetes

415

25,00

56

38,10

,001

COPD

151

9,10

24

16,30

,008

NYHA:I

473

28,20

29

19,50

,002

II

700

41,80

53

35,60

 

III

439

26,20

57

38,30

 

IV

64

3,80

10

6,70

 

Type: Emergent

32

1,90

5

3,40

,25

Scheduled

1448

86,30

122

81,90

 

Urgent

198

11,80

22

14,80

 

Conclusions

Age, having COPD or NYHA class to undergo cardiac surgery, are prognostic factors for the development of permanent renal injury. These factors should be considered in risk stratification prior to surgery.

Authors’ Affiliations

(1)
Granada University, ICU Complejo Hospitalario, Granada, Spain

Copyright

© Rodriguez Mejias et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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