Department of Cardiovascular Surgery, The Southern District of the First Affiliated Hospital of University of Science and Technology of China.
the First Affiliated Hospital of University of Science and Technology of China.
Heart Surg Forum. 2020 Dec 22;23(6):E902-E926. doi: 10.1532/hsf.3443.
The relationship between perioperative hyperchloremia and postoperative acute kidney injury (AKI) is not well established. Our study aimed to evaluate the association between perioperative hyperchloremia and acute kidney injury in patients undergoing off-pump coronary artery bypass grafting (CABG).
Patients with coronary disease who underwent off-pump CABG between April 2017 and December 2019 were enrolled in this retrospective study. The patients with perioperative hyperchloremia were matched 1:1 to patients without perioperative hyperchloremia. The primary outcome was the postoperative acute kidney injury rate. The secondary outcomes included intensive care unit (ICU)-free days, postoperative hospitalization days, wound infection rate, and in-hospital mortality. Propensity score matching and univariate and multivariate logistic regression analyses were used in this study.
A total of 321 patients who underwent off-pump CABG were included in the analysis. Propensity score matching selected 83 pairs for the final comparison. The results showed that the postoperative AKI rate was significantly different between the hyperchloremia and no hyperchloremia groups (56.6% versus 15.7%; P < .001). The number of ICU-free days, postoperative hospitalization days, wound infection rate, and in-hospital mortality were similar between the two groups. In the multivariable, logistic regression analysis, hyperchloremia was independently associated with the development of postoperative AKI (odds ratio [OR] = 1.814, 95% confidence interval [CI]: 1.072-3.070, P = .026).
Perioperative hyperchloremia is associated with an increase in the postoperative AKI rate among patients undergoing off-pump CABG.
围手术期高氯血症与术后急性肾损伤（AKI）之间的关系尚未明确。我们的研究旨在评估非体外循环冠状动脉旁路移植术（CABG）患者围手术期高氯血症与急性肾损伤之间的关系。
本回顾性研究纳入了 2017 年 4 月至 2019 年 12 月期间接受非体外循环 CABG 的冠心病患者。将围手术期高氯血症患者与无围手术期高氯血症患者进行 1:1 匹配。主要结局是术后急性肾损伤发生率。次要结局包括重症监护病房（ICU）无天数、术后住院天数、伤口感染率和住院死亡率。本研究采用倾向评分匹配和单因素及多因素逻辑回归分析。
共纳入 321 例接受非体外循环 CABG 的患者进行分析。倾向评分匹配选择了 83 对进行最终比较。结果显示，高氯血症组和无高氯血症组术后 AKI 发生率差异有统计学意义（56.6%比 15.7%；P<0.001）。两组 ICU 无天数、术后住院天数、伤口感染率和住院死亡率相似。在多变量逻辑回归分析中，高氯血症与术后 AKI 的发生独立相关（比值比[OR] = 1.814，95%置信区间[CI]：1.072-3.070，P=0.026）。
非体外循环 CABG 患者围手术期高氯血症与术后 AKI 发生率增加相关。
