Alhamad Fahad S, Almohaimeed Yazeed S, Alhayzan Majd H, Alturaymi Mouath A, Almutairi Khaled Z, Almuhanna Abdullah, Alminhali Sumayyah, Elhassan Elwaleed
College of Medicine, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, SAU.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Cureus. 2023 Aug 12;15(8):e43381. doi: 10.7759/cureus.43381. eCollection 2023 Aug.
Despite recent advancements in techniques, peri- and post-procedural complications still pose a significant challenge in the high-risk transcatheter aortic valve replacement (TAVR) patient population. This study aims to investigate and assess the prevalence of acute kidney injury (AKI) following TAVR, and to identify the risk factors associated with its occurrence.
We conducted the study at King Abdulaziz Medical City, Riyadh, Saudi Arabia from January 2016 to December 2022. We extracted data from electronic medical records. We categorized and compared patients based on their diagnosis of AKI+ following TAVR, or their absence of AKI- after the procedure.
The study included a total of 344 patients who underwent TAVR. The mean age of the patients was 77.8 ± 8.9 years, 61.8% were male, and the average body mass index was 30.5±7.0. In terms of comorbidities, 70.8% of the patients had diabetes mellitus, 80.5% had hypertension, 8.7% had hypothyroidism, 2.0% had hematological disorders, 23.6% had congestive heart disease, 20.4% had cerebrovascular disease, 4.1% had peripheral vascular disease, 7.3% had cancer, and 34.4% had other comorbidities. The prevalence of AKI was 60 (17.50%) following the procedure. Cerebrovascular diseases showed a significant association with AKI (OR= 3.381, 95% CI, 1.65-6.91, p = 0.001). Chronic kidney disease has a significant effect on AKI (OR = 2.56, 95%CI, 1.02-6.39, p = 0.044). The creatinine level on Day 0 has a significant association with AKI (OR = 1.01, 95%CI, 1.006-1.017, p = 0.0001).
These findings highlight the importance of assessing and managing these risk factors (cerebrovascular diseases, chronic kidney disease, and creatinine level on Day 0) in TAVR patients to mitigate the occurrence and severity of AKI. By understanding and addressing these factors, healthcare providers can potentially improve patient outcomes and reduce the incidence of AKI-associated TAVR procedures.
尽管技术上最近有所进步，但围手术期和术后并发症在高风险经导管主动脉瓣置换术（TAVR）患者群体中仍然构成重大挑战。本研究旨在调查和评估TAVR术后急性肾损伤（AKI）的发生率，并确定与其发生相关的风险因素。
我们于2016年1月至2022年12月在沙特阿拉伯利雅得的阿卜杜勒阿齐兹国王医疗城进行了这项研究。我们从电子病历中提取数据。我们根据患者TAVR术后AKI+的诊断或术后无AKI-对患者进行分类和比较。
该研究共纳入344例接受TAVR的患者。患者的平均年龄为77.8±8.9岁，61.8%为男性，平均体重指数为30.5±7.0。在合并症方面，70.8%的患者患有糖尿病，80.5%患有高血压，8.7%患有甲状腺功能减退症，2.0%患有血液系统疾病，23.6%患有充血性心力衰竭，20.4%患有脑血管疾病，4.1%患有周围血管疾病，7.3%患有癌症，34.4%患有其他合并症。术后AKI的发生率为60例（17.50%）。脑血管疾病与AKI显著相关（OR=3.381，95%CI，1.65-6.91，p=0.001）。慢性肾脏病对AKI有显著影响（OR=2.56，95%CI，1.02-6.39，p=0.044）。第0天的肌酐水平与AKI显著相关（OR=1.01，95%CI，1.006-1.017，p=0.0001）。
这些发现强调了评估和管理TAVR患者中的这些风险因素（脑血管疾病、慢性肾脏病和第0天的肌酐水平）以减轻AKI的发生和严重程度的重要性。通过了解和解决这些因素，医疗保健提供者可以潜在地改善患者预后并降低与AKI相关的TAVR手术的发生率。
