Jiang Yun, Chen Jianle, Yu Yamin, Yang Fan, Hamza Mohsin, Zou Ping, Wen Ailing, Wu Huihui, Zhang Yide
Cardiothoracic Department, The Affiliated Hospital of Nantong University, Jiangsu, China.
Nehrology Department, The Ningxiang People's Hospital, Hunan, China.
Clin Exp Nephrol. 2022 Dec;26(12):1233-1239. doi: 10.1007/s10157-022-02274-1. Epub 2022 Sep 9.
We retrospectively analyzed risk factors on in-hospital mortality in CRRT-therapy patients with open cardiac surgery (CS)-induced acute kidney injury (AKI), to provide the clinical basis for predicting and lowering the in-hospital mortality after CS.
84 CS-AKI patients with CRRT were divided into survival and death groups according to discharge status, and the perioperative data were analyzed with R version 4.0.2.
There were significant differences between the two groups, including: urea nitrogen, Sequential Organ Failure Assessment (SOFA) score and vasoactive-inotropic score (VIS) on the first day after operation; VIS just before CRRT; SOFA score and negative balance of blood volume 24 h after CRRT; the incidence rate of bleeding, severe infection and MODS after operation; and the interval between AKI and CRRT. Univariate logistic regression analysis showed that SOFA score and VIS on the first day after operation; VIS just before CRRT; VIS and negative balance of blood volume 24 h after CRRT; the incidence rate of bleeding, infection and multiple organ dysfunction syndrome (MODS) after operation; bootstrap resampling analysis showed that SOFA score and VIS 24 h after CRRT, as well as the incidence of bleeding after operation were the independent risk factors.
Maintaining stable hemodynamics and active prevention of bleeding are expected to decrease the in-hospital mortality.
回顾性分析心脏直视手术(CS)所致急性肾损伤(AKI)行连续性肾脏替代治疗(CRRT)患者院内死亡的危险因素,为预测和降低CS术后院内死亡率提供临床依据。
将84例接受CRRT治疗的CS-AKI患者按出院状态分为存活组和死亡组,采用R 4.0.2版本分析围手术期数据。
两组间存在显著差异,包括:术后第1天的尿素氮、序贯器官衰竭评估(SOFA)评分和血管活性药物评分(VIS);CRRT前的VIS;CRRT后24小时的SOFA评分和血容量负平衡;术后出血、严重感染和多器官功能障碍综合征(MODS)的发生率;以及AKI与CRRT的间隔时间。单因素logistic回归分析显示,术后第1天的SOFA评分和VIS;CRRT前的VIS;CRRT后24小时的VIS和血容量负平衡;术后出血、感染和多器官功能障碍综合征(MODS)的发生率;自抽样分析显示,CRRT后24小时的SOFA评分和VIS以及术后出血发生率是独立危险因素。
维持稳定的血流动力学并积极预防出血有望降低院内死亡率。