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非体外循环冠状动脉旁路移植术(OCABG)手术结果:急性肾损伤发生率、血清尿酸及变量临界值

Off-Pump Coronary Artery Bypass Graft (OCABG) Surgery Outcome: AKI Incidence, Serum Uric Acid, and Cut-Offs of Variables.

作者信息

Zare-Khormizi Mohamad Reza, Pourrajab Fatemeh

机构信息

Cardiovascular Research Center Institute of Basic and Clinical Physiology Sciences Kerman University of Medical Sciences, Kerman, Iran.

School of Medicine Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Cardiovasc Ther. 2024 Jul 4;2024:5945687. doi: 10.1155/2024/5945687. eCollection 2024.

Abstract

One of the most important challenges of the medical community is to find out the success rate of coronary artery bypass surgery and control complications after surgery, including acute kidney injury (AKI). The present study was conducted with the aim of determining the predictive effect of serum uric acid (SUA) (UA) level in patients undergoing off-pump coronary artery bypass (OCABG) surgery. The present descriptive-analytical study included 144 patients who underwent OCABG and met the inclusion criteria. SUA and related indicators, duration of hospitalization and stay in ICU, AKI and in-hospital mortality, and 6-month follow-up mortality were investigated. Patients were divided into high and normal groups based on SUA levels. The prevalence of postoperative AKI was 20% and was significantly associated with the preoperative UA levels (OR: 2.04; CI: 95%; 1.03-4.20). The mortality rate of patients was between 2% and 9%, which increased to 13% in patients with high SUA ( value ~0.224). The average duration of ICU and hospitalization in patients with high UA was longer than the other group ( value ~0.06 and value ~0.002, respectively). SUA levels are independently associated with a higher risk of AKI and outcome complications after off-pump CABG, and confounding factors at specific cutoffs affect the odds ratio of UA for AKI occurrence.

摘要

医学界面临的最重要挑战之一是找出冠状动脉搭桥手术的成功率,并控制术后并发症,包括急性肾损伤(AKI)。本研究旨在确定血清尿酸(SUA)(UA)水平对非体外循环冠状动脉搭桥(OCABG)手术患者的预测作用。本描述性分析研究纳入了144例接受OCABG手术且符合纳入标准的患者。对SUA及相关指标、住院时间和ICU停留时间、AKI和院内死亡率以及6个月随访死亡率进行了调查。根据SUA水平将患者分为高尿酸组和正常尿酸组。术后AKI的发生率为20%,且与术前UA水平显著相关(OR:2.04;CI:95%;1.03 - 4.20)。患者死亡率在2%至9%之间,高尿酸患者的死亡率增至13%( 值约为0.224)。高尿酸患者的ICU平均停留时间和住院时间均长于另一组( 值分别约为0.06和 值约为0.002)。SUA水平与非体外循环冠状动脉搭桥术后AKI风险及结局并发症独立相关,特定临界值下的混杂因素影响UA导致AKI发生的比值比。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c889/11239226/ca22cdaa6107/CDTP2024-5945687.001.jpg

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