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Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection
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| Zeitschriftentitel: | Interactive CardioVascular and Thoracic Surgery |
|---|---|
| Personen und Körperschaften: | , , , , , , , , |
| In: | Interactive CardioVascular and Thoracic Surgery, 30, 2020, 1, S. 107-112 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Oxford University Press (OUP)
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| Schlagwörter: |
| author_facet |
Amano, Kentaro Takami, Yoshiyuki Ishikawa, Hiroshi Ishida, Michiko Tochii, Masato Akita, Kiyotoshi Sakurai, Yusuke Noda, Mika Takagi, Yasushi Amano, Kentaro Takami, Yoshiyuki Ishikawa, Hiroshi Ishida, Michiko Tochii, Masato Akita, Kiyotoshi Sakurai, Yusuke Noda, Mika Takagi, Yasushi |
|---|---|
| author |
Amano, Kentaro Takami, Yoshiyuki Ishikawa, Hiroshi Ishida, Michiko Tochii, Masato Akita, Kiyotoshi Sakurai, Yusuke Noda, Mika Takagi, Yasushi |
| spellingShingle |
Amano, Kentaro Takami, Yoshiyuki Ishikawa, Hiroshi Ishida, Michiko Tochii, Masato Akita, Kiyotoshi Sakurai, Yusuke Noda, Mika Takagi, Yasushi Interactive CardioVascular and Thoracic Surgery Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Surgery |
| author_sort |
amano, kentaro |
| spelling |
Amano, Kentaro Takami, Yoshiyuki Ishikawa, Hiroshi Ishida, Michiko Tochii, Masato Akita, Kiyotoshi Sakurai, Yusuke Noda, Mika Takagi, Yasushi 1569-9285 Oxford University Press (OUP) Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Surgery http://dx.doi.org/10.1093/icvts/ivz220 <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>Postoperative acute kidney injury (AKI) is known as a risk factor for death after surgery for Stanford type A acute aortic dissection under hypothermic circulatory arrest. It may also adversely affect long-term survival. We searched for modifiable risk factors for postoperative AKI, focusing on lower body ischaemic time.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>We reviewed 191 patients undergoing surgical repair for Stanford type A acute aortic dissection. The distal anastomosis depended on excluding the primary tear location, resulting in ascending/hemiarch (n = 119), partial arch (n = 18) and total arch replacement (n = 54). We defined an increase in the serum creatinine level to ≧2 times the baseline level as AKI. The incidence of AKI was investigated with multivariate analysis of its risk factors.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Postoperative AKI was observed in 49 patients (26%), 31% of whom required renal replacement therapy. The overall hospital mortality rate was 8.5%. Postoperative AKI, preoperative shock and organ malperfusion were predictors of hospital death. Multivariate stepwise logistic regression analysis identified age, body mass index, preoperative chronic kidney disease and lower body ischaemic time as risk factors for postoperative AKI.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Although surgical repair for Stanford type A acute aortic dissection showed favourable results, the incidence of postoperative AKI is still high, closely associated with hospital death. Lower body ischaemic time should be recognized specifically as a modifiable surgical risk factor for postoperative AKI.</jats:p> </jats:sec> Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection Interactive CardioVascular and Thoracic Surgery |
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| title |
Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_unstemmed |
Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_full |
Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_fullStr |
Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_full_unstemmed |
Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_short |
Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_sort |
lower body ischaemic time is a risk factor for acute kidney injury after surgery for type a acute aortic dissection |
| topic |
Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Surgery |
| url |
http://dx.doi.org/10.1093/icvts/ivz220 |
| publishDate |
2020 |
| physical |
107-112 |
| description |
<jats:title>Abstract</jats:title>
<jats:p />
<jats:sec>
<jats:title>OBJECTIVES</jats:title>
<jats:p>Postoperative acute kidney injury (AKI) is known as a risk factor for death after surgery for Stanford type A acute aortic dissection under hypothermic circulatory arrest. It may also adversely affect long-term survival. We searched for modifiable risk factors for postoperative AKI, focusing on lower body ischaemic time.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>METHODS</jats:title>
<jats:p>We reviewed 191 patients undergoing surgical repair for Stanford type A acute aortic dissection. The distal anastomosis depended on excluding the primary tear location, resulting in ascending/hemiarch (n = 119), partial arch (n = 18) and total arch replacement (n = 54). We defined an increase in the serum creatinine level to ≧2 times the baseline level as AKI. The incidence of AKI was investigated with multivariate analysis of its risk factors.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>RESULTS</jats:title>
<jats:p>Postoperative AKI was observed in 49 patients (26%), 31% of whom required renal replacement therapy. The overall hospital mortality rate was 8.5%. Postoperative AKI, preoperative shock and organ malperfusion were predictors of hospital death. Multivariate stepwise logistic regression analysis identified age, body mass index, preoperative chronic kidney disease and lower body ischaemic time as risk factors for postoperative AKI.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>CONCLUSIONS</jats:title>
<jats:p>Although surgical repair for Stanford type A acute aortic dissection showed favourable results, the incidence of postoperative AKI is still high, closely associated with hospital death. Lower body ischaemic time should be recognized specifically as a modifiable surgical risk factor for postoperative AKI.</jats:p>
</jats:sec> |
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| author | Amano, Kentaro, Takami, Yoshiyuki, Ishikawa, Hiroshi, Ishida, Michiko, Tochii, Masato, Akita, Kiyotoshi, Sakurai, Yusuke, Noda, Mika, Takagi, Yasushi |
| author_facet | Amano, Kentaro, Takami, Yoshiyuki, Ishikawa, Hiroshi, Ishida, Michiko, Tochii, Masato, Akita, Kiyotoshi, Sakurai, Yusuke, Noda, Mika, Takagi, Yasushi, Amano, Kentaro, Takami, Yoshiyuki, Ishikawa, Hiroshi, Ishida, Michiko, Tochii, Masato, Akita, Kiyotoshi, Sakurai, Yusuke, Noda, Mika, Takagi, Yasushi |
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| description | <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>Postoperative acute kidney injury (AKI) is known as a risk factor for death after surgery for Stanford type A acute aortic dissection under hypothermic circulatory arrest. It may also adversely affect long-term survival. We searched for modifiable risk factors for postoperative AKI, focusing on lower body ischaemic time.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>We reviewed 191 patients undergoing surgical repair for Stanford type A acute aortic dissection. The distal anastomosis depended on excluding the primary tear location, resulting in ascending/hemiarch (n = 119), partial arch (n = 18) and total arch replacement (n = 54). We defined an increase in the serum creatinine level to ≧2 times the baseline level as AKI. The incidence of AKI was investigated with multivariate analysis of its risk factors.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Postoperative AKI was observed in 49 patients (26%), 31% of whom required renal replacement therapy. The overall hospital mortality rate was 8.5%. Postoperative AKI, preoperative shock and organ malperfusion were predictors of hospital death. Multivariate stepwise logistic regression analysis identified age, body mass index, preoperative chronic kidney disease and lower body ischaemic time as risk factors for postoperative AKI.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Although surgical repair for Stanford type A acute aortic dissection showed favourable results, the incidence of postoperative AKI is still high, closely associated with hospital death. Lower body ischaemic time should be recognized specifically as a modifiable surgical risk factor for postoperative AKI.</jats:p> </jats:sec> |
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| institution | DE-Brt1, DE-D161, DE-Zwi2, DE-Gla1, DE-Zi4, DE-15, DE-Pl11, DE-Rs1, DE-105, DE-14, DE-Ch1, DE-L229, DE-D275, DE-Bn3 |
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| spelling | Amano, Kentaro Takami, Yoshiyuki Ishikawa, Hiroshi Ishida, Michiko Tochii, Masato Akita, Kiyotoshi Sakurai, Yusuke Noda, Mika Takagi, Yasushi 1569-9285 Oxford University Press (OUP) Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Surgery http://dx.doi.org/10.1093/icvts/ivz220 <jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>Postoperative acute kidney injury (AKI) is known as a risk factor for death after surgery for Stanford type A acute aortic dissection under hypothermic circulatory arrest. It may also adversely affect long-term survival. We searched for modifiable risk factors for postoperative AKI, focusing on lower body ischaemic time.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>We reviewed 191 patients undergoing surgical repair for Stanford type A acute aortic dissection. The distal anastomosis depended on excluding the primary tear location, resulting in ascending/hemiarch (n = 119), partial arch (n = 18) and total arch replacement (n = 54). We defined an increase in the serum creatinine level to ≧2 times the baseline level as AKI. The incidence of AKI was investigated with multivariate analysis of its risk factors.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Postoperative AKI was observed in 49 patients (26%), 31% of whom required renal replacement therapy. The overall hospital mortality rate was 8.5%. Postoperative AKI, preoperative shock and organ malperfusion were predictors of hospital death. Multivariate stepwise logistic regression analysis identified age, body mass index, preoperative chronic kidney disease and lower body ischaemic time as risk factors for postoperative AKI.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Although surgical repair for Stanford type A acute aortic dissection showed favourable results, the incidence of postoperative AKI is still high, closely associated with hospital death. Lower body ischaemic time should be recognized specifically as a modifiable surgical risk factor for postoperative AKI.</jats:p> </jats:sec> Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection Interactive CardioVascular and Thoracic Surgery |
| spellingShingle | Amano, Kentaro, Takami, Yoshiyuki, Ishikawa, Hiroshi, Ishida, Michiko, Tochii, Masato, Akita, Kiyotoshi, Sakurai, Yusuke, Noda, Mika, Takagi, Yasushi, Interactive CardioVascular and Thoracic Surgery, Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Surgery |
| title | Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_full | Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_fullStr | Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_full_unstemmed | Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_short | Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| title_sort | lower body ischaemic time is a risk factor for acute kidney injury after surgery for type a acute aortic dissection |
| title_unstemmed | Lower body ischaemic time is a risk factor for acute kidney injury after surgery for type A acute aortic dissection |
| topic | Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Surgery |
| url | http://dx.doi.org/10.1093/icvts/ivz220 |