Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden.
Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
J Cardiothorac Vasc Anesth. 2022 Apr;36(4):962-970. doi: 10.1053/j.jvca.2021.11.036. Epub 2021 Nov 26.
To assess sex differences in short- and long-term mortality in patients who develop acute kidney injury (AKI) after coronary artery bypass grafting (CABG).
An observational cohort study.
A multicenter, nationwide, population-based, observational cohort study.
All patients (n = 32,013) who underwent primary nonemergent isolated CABG in Sweden between January 1, 2003, and December 31, 2013.
AKI and its association with 90-day mortality were analyzed using logistic regression. AKI and its association with long-term mortality were analyzed using Cox regression analysis.
AKI was defined as an absolute increase by 26 µmol/L or a relative increase by 50% postoperatively compared with the preoperative serum creatinine concentration. Ninety-day mortality was defined as death by any cause within 90 days after surgery. Long-term mortality was defined as death by any cause from day 91 after surgery to the end of the study period. In total, 13.9% of women and 14.4% of men developed AKI after CABG. The multivariate-adjusted odds ratio (95% confidence interval [CI]) for death within 90 days in patients with AKI compared to those without AKI was 5.1 (3.6-7.2) and 5.2 (4.2-6.6) in women and men, respectively (p for interaction = 0.74). The multivariate-adjusted hazard ratio (95% CI) for long-term death in those with AKI compared to those without AKI was 1.4 (1.2-1.7) and 1.3 (1.2-1.4) in women and men, respectively (p for interaction = 0.27).
AKI after CABG was associated with a similar increase in 90-day and long-term mortality in both women and men.
评估冠状动脉旁路移植术（CABG）后发生急性肾损伤（AKI）的患者短期和长期死亡率的性别差异。
观察性队列研究。
多中心、全国性、基于人群的观察性队列研究。
2003 年 1 月 1 日至 2013 年 12 月 31 日期间在瑞典接受初次非紧急单纯 CABG 的所有患者（n=32013）。
使用逻辑回归分析 AKI 及其与 90 天死亡率的关系。使用 Cox 回归分析 AKI 及其与长期死亡率的关系。
AKI 的定义为与术前血清肌酐浓度相比，术后绝对值增加 26 μmol/L 或相对增加 50%。90 天死亡率定义为手术后 90 天内任何原因导致的死亡。长期死亡率定义为手术后第 91 天至研究结束时任何原因导致的死亡。共有 13.9%的女性和 14.4%的男性在 CABG 后发生 AKI。与无 AKI 的患者相比，AKI 患者 90 天内死亡的多变量调整比值比（95%置信区间[CI]）为 5.1（3.6-7.2）和 5.2（4.2-6.6），女性和男性分别为（p 交互=0.74）。与无 AKI 的患者相比，AKI 患者长期死亡的多变量调整风险比（95%CI）为 1.4（1.2-1.7）和 1.3（1.2-1.4），女性和男性分别为（p 交互=0.27）。
CABG 后 AKI 与女性和男性的 90 天和长期死亡率增加相似相关。
