Cardiovascular Surgery Clinic, Derince Training and Research Hospital, Health Sciences University, Kocaeli, Turkey. Email:
Cardiovascular Surgery Clinic, Derince Training and Research Hospital, Health Sciences University, Kocaeli, Turkey.
Cardiovasc J Afr. 2023;34(4):198-205. doi: 10.5830/CVJA-2022-035. Epub 2022 Aug 1.
The association between pre-operative carotid intima-media thickness (CIMT) and early postoperative acute kidney injury (AKI) following isolated coronary artery bypass grafting (CABG) was investigated.
Data were sought retrospectively of 237 patients (166 male, 71 female; mean age 61.4 ± 8.1 years; range: 32-74), operated on for isolated CABG with cardiopulmonary bypass (CPB) in a single centre between June 2014 and December 2020, with a serum creatinine level < 1.5 mg/dl and normal carotid arteries on Doppler ultrasonography. AKI diagnosis was made according to the Kidney Disease Improving Global Outcomes 2012 Acute Kidney Injury Guideline. Patients were grouped as group 1 with AKI in the early postoperative period ( = 63) and group 2 without AKI ( = 174). Univariate analyses were done to determine significant clinical factors, and subsequent multiple logistic regression analysis was done to determine independent predictors of AKI.
AKI occurred in 63 (26.6%) patients. Pre-operative CIMT was significantly higher in the AKI group ( = 0.0001). Multivariate logistic regression analysis revealed that elevated pre-operative CIMT ( = 0.005), C-reactive protein ( = 0.001), erythrocyte sedimentation rate ( = 0.005), neutrophil-lymphocyte ratio ( = 0.0001) and platelet-lymphocyte ratio ( = 0.0001) increased on the postoperative seventh day. C-reactive protein ( = 0.04), postoperative first day platelet- lymphocyte ratio ( = 0.0001), postoperative seventh day erythrocyte sedimentation rate ( = 0.02) and intubation time ( = 0.02) were independent predictors of early postoperative AKI following isolated CABG.
Pre-operative CIMT was found to be an independent predictor of AKI in the early postoperative period of isolated CABG.
研究孤立冠状动脉旁路移植术（CABG）患者术前颈动脉内膜中层厚度（CIMT）与术后早期急性肾损伤（AKI）之间的关系。
回顾性分析 2014 年 6 月至 2020 年 12 月在单一中心接受体外循环（CPB）下孤立 CABG 手术的 237 例患者（男 166 例，女 71 例；平均年龄 61.4 ± 8.1 岁；范围：32-74 岁）的数据，这些患者术前血清肌酐水平＜1.5mg/dl，且多普勒超声检查提示颈动脉正常。AKI 的诊断依据是 2012 年改善全球肾脏病预后组织急性肾损伤指南。根据术后早期是否发生 AKI 将患者分为 AKI 组（63 例）和非 AKI 组（174 例）。进行单因素分析以确定有意义的临床因素，随后进行多因素逻辑回归分析以确定 AKI 的独立预测因素。
63 例（26.6%）患者发生 AKI。AKI 组患者术前 CIMT 明显升高（ = 0.0001）。多因素逻辑回归分析显示，术前 CIMT 升高（ = 0.005）、C 反应蛋白（ = 0.001）、红细胞沉降率（ = 0.005）、中性粒细胞-淋巴细胞比值（ = 0.0001）和血小板-淋巴细胞比值（ = 0.0001）升高，术后第 7 天 CRP（ = 0.04）、术后第 1 天血小板-淋巴细胞比值（ = 0.0001）、术后第 7 天红细胞沉降率（ = 0.02）和插管时间（ = 0.02）是孤立 CABG 术后早期 AKI 的独立预测因素。
术前 CIMT 是孤立 CABG 术后早期 AKI 的独立预测因素。
