大小不均预测行心脏瓣膜手术的患者术后需要肾脏替代治疗。
Anisocytosis predicts postoperative renal replacement therapy in patients undergoing heart valve surgery.
机构信息
Department of Acquired Cardiac Defects, Institute of Cardiology, Alpejska 42, Warsaw, Poland.
出版信息
Cardiol J. 2020;27(4):362-367. doi: 10.5603/CJ.a2019.0020. Epub 2019 Feb 25.
Abstract
BACKGROUND
Acute kidney injury (AKI) is one of the serious postoperative complications in patients undergoing heart valve surgery. The aim of the present study was to identify selected biomarkers to predict AKI requiring renal replacement.
METHODS
A prospective study was conducted on a group of 751 patients undergoing heart valve surgery. The data on risk factors, preoperative complete blood count, course of operations and postoperative period was assessed. The primary endpoint at the 30-day follow-up was postoperative AKI requiring renal replacement therapy. The secondary end-point was death from all causes in patients with postoperative AKI requiring renal replacement.
RESULTS
The primary endpoint occurred in 46 patients. At multivariate analysis: age, red cell distribution width (RDW) and C-reactive protein remained independent predictors of the primary endpoint. Hemoglobin and RDW were associated with an increased risk of death.
CONCLUSIONS
Elevated RDW is associated with a higher risk of postoperative AKI and death in patients with AKI.
摘要
背景
急性肾损伤（AKI）是心脏瓣膜手术后患者的严重术后并发症之一。本研究的目的是确定一些有预测价值的生物标志物，用于预测需要肾脏替代治疗的 AKI。
方法
对 751 例接受心脏瓣膜手术的患者进行了前瞻性研究。评估了危险因素、术前全血细胞计数、手术过程和术后期间的数据。术后 30 天的主要终点是需要肾脏替代治疗的术后 AKI。次要终点是术后 AKI 需要肾脏替代治疗的患者的全因死亡。
结果
主要终点发生在 46 例患者中。多变量分析显示：年龄、红细胞分布宽度（RDW）和 C 反应蛋白仍然是主要终点的独立预测因素。血红蛋白和 RDW 与死亡风险增加相关。
结论
在 AKI 患者中，升高的 RDW 与术后 AKI 和死亡的风险增加相关。
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